Cell evolution and Earth history: stasis and revolution.

Science.gov (United States)

Cavalier-Smith, Thomas

2006-06-29

This synthesis has three main parts. The first discusses the overall tree of life and nature of the last common ancestor (cenancestor). I emphasize key steps in cellular evolution important for ordering and timing the major evolutionary innovations in the history of the biosphere, explaining especially the origins of the eukaryote cell and of bacterial flagella and cell envelope novelties. Second, I map the tree onto the fossil record and discuss dates of key events and their biogeochemical impact. Finally, I present a broad synthesis, discussing evidence for a three-phase history of life. The first phase began perhaps ca 3.5 Gyr ago, when the origin of cells and anoxic photosynthesis generated the arguably most primitive prokaryote phylum, Chlorobacteria (= Chloroflexi), the first negibacteria with cells bounded by two acyl ester phospholipid membranes. After this 'chlorobacterial age' of benthic anaerobic evolution protected from UV radiation by mineral grains, two momentous quantum evolutionary episodes of cellular innovation and microbial radiation dramatically transformed the Earth's surface: the glycobacterial revolution initiated an oxygenic 'age of cyanobacteria' and, as the ozone layer grew, the rise of plankton; immensely later, probably as recently as ca 0.9 Gyr ago, the neomuran revolution ushered in the 'age of eukaryotes', Archaebacteria (arguably the youngest bacterial phylum), and morphological complexity. Diversification of glycobacteria ca 2.8 Gyr ago, predominantly inhabiting stratified benthic mats, I suggest caused serial depletion of 13C by ribulose 1,5-bis-phosphate caboxylase/oxygenase (Rubisco) to yield ultralight late Archaean organic carbon formerly attributed to methanogenesis plus methanotrophy. The late origin of archaebacterial methanogenesis ca 720 Myr ago perhaps triggered snowball Earth episodes by slight global warming increasing weathering and reducing CO2 levels, to yield runaway cooling; the origin of anaerobic methane

THE INFLUENCE OF PRESSURE-DEPENDENT VISCOSITY ON THE THERMAL EVOLUTION OF SUPER-EARTHS

Energy Technology Data Exchange (ETDEWEB)

Stamenkovic, Vlada; Noack, Lena; Spohn, Tilman [Institute of Planetology, Westfaelische Wilhelms-Universitaet Muenster, Wilhelm-Klemm-Str. 10, 48149 Muenster (Germany); Breuer, Doris, E-mail: Vlada.Stamenkovic@dlr.de, E-mail: Lena.Noack@dlr.de, E-mail: Doris.Breuer@dlr.de, E-mail: Tilman.Spohn@dlr.de [Institute of Planetary Research, German Aerospace Center DLR, Rutherfordstrasse 2, 12489 Berlin (Germany)

2012-03-20

We study the thermal evolution of super-Earths with a one-dimensional (1D) parameterized convection model that has been adopted to account for a strong pressure dependence of the viscosity. A comparison with a 2D spherical convection model shows that the derived parameterization satisfactorily represents the main characteristics of the thermal evolution of massive rocky planets. We find that the pressure dependence of the viscosity strongly influences the thermal evolution of super-Earths-resulting in a highly sluggish convection regime in the lower mantles of those planets. Depending on the effective activation volume and for cooler initial conditions, we observe with growing planetary mass even the formation of a conductive lid above the core-mantle boundary (CMB), a so-called CMB-lid. For initially molten planets our results suggest no CMB-lids but instead a hot lower mantle and core as well as sluggish lower mantle convection. This implies that the initial interior temperatures, especially in the lower mantle, become crucial for the thermal evolution-the thermostat effect suggested to regulate the interior temperatures in terrestrial planets does not work for massive planets if the viscosity is strongly pressure dependent. The sluggish convection and the potential formation of the CMB-lid reduce the convective vigor throughout the mantle, thereby affecting convective stresses, lithospheric thicknesses, and heat fluxes. The pressure dependence of the viscosity may therefore also strongly affect the propensity of plate tectonics, volcanic activity, and the generation of a magnetic field of super-Earths.

The Role and Evolution of NASA's Earth Science Data Systems

Science.gov (United States)

Ramapriyan, H. K.

2015-01-01

One of the three strategic goals of NASA is to Advance understanding of Earth and develop technologies to improve the quality of life on our home planet (NASA strategic plan 2014). NASA's Earth Science Data System (ESDS) Program directly supports this goal. NASA has been launching satellites for civilian Earth observations for over 40 years, and collecting data from various types of instruments. Especially since 1990, with the start of the Earth Observing System (EOS) Program, which was a part of the Mission to Planet Earth, the observations have been significantly more extensive in their volumes, variety and velocity. Frequent, global observations are made in support of Earth system science. An open data policy has been in effect since 1990, with no period of exclusive access and non-discriminatory access to data, free of charge. NASA currently holds nearly 10 petabytes of Earth science data including satellite, air-borne, and ground-based measurements and derived geophysical parameter products in digital form. Millions of users around the world are using NASA data for Earth science research and applications. In 2014, over a billion data files were downloaded by users from NASAs EOS Data and Information System (EOSDIS), a system with 12 Distributed Active Archive Centers (DAACs) across the U. S. As a core component of the ESDS Program, EOSDIS has been operating since 1994, and has been evolving continuously with advances in information technology. The ESDS Program influences as well as benefits from advances in Earth Science Informatics. The presentation will provide an overview of the role and evolution of NASAs ESDS Program.

Theory for the Origin and Evolution of Stars and Planets, Including Earth

Science.gov (United States)

Cimorelli, S. A.; Samuels, C.

2001-05-01

In this paper we present a novel hypothesis for the formation and evolution of galaxies, stars (including black holes (BHs), giant, mid-size, dwarf, dying and dead stars), planets (including earth), and moons. Present day phenomenon will be used to substantiate the validity of this hypothesis. Every `body' is a multiple type of star, generated from pieces called particle proliferators, of a dislodged/expanded BH which explodes due to a collision with another expanded BH. This includes the sun, and the planet earth, which is a type of dead star. Such that, if we remove layers of the earth, starting with the crust, we will find evidence of each preceding star formation, such as a brown star, a red star, a white star, a blue star, and the remains of the particle proliferator as the innermost core is reached. We intend to show that the hypothesis is consistent with both the available astronomical data regarding stellar evolution and planetary formation; as well as the evolution of the earth itself, by considerations of the available geophysical data. Where data is not available, reasonably simple experiments will be suggested to demonstrate further the consistency and viability of the hypothesis. Theories are presented to help define and explain phenomenon such as how two (or more) BHs expand and collide to form a small `big bang' (it is postulated that there was a small big bang to form each galaxy). This in turn afforded the material/matter to form all the galactic bodies, including the dark matter. The start and development of the planet earth, initially as an emergent piece from the colliding BHs, is given special attention to explain the continuing expansion/growth that takes place in all stars and planets. Also, to explain the formation of the land, the growing/expanding earth (proportional to the ocean bed growth), the division of the continents, and the formation of the ocean beds (possibly long before the oceans existed). Attempts will be made to explain the

Life from the stars?. [extraterrestrial sources contributing to chemical evolution on Earth

Science.gov (United States)

Pendleton, Yvonne J.; Cruikshank, Dale P.

1994-01-01

Scientists are now seriously considering the possibility that organic matter from interstellar space could have influenced, or even spurred, the origin of life on Earth. Various aspects of chemical evolution are discussed along with possible extraterrestrial sources responsible for contributing to Earth's life-producing, chemical composition. Specific topics covered include the following: interstellar matter, molecular clouds, asteroid dust, organic molecules in our solar system, interplanetary dust and comets, meteoritic composition, and organic-rich solar-system bodies.

Prescription-induced jump distributions in multiplicative Poisson processes.

Science.gov (United States)

Suweis, Samir; Porporato, Amilcare; Rinaldo, Andrea; Maritan, Amos

2011-06-01

Generalized Langevin equations (GLE) with multiplicative white Poisson noise pose the usual prescription dilemma leading to different evolution equations (master equations) for the probability distribution. Contrary to the case of multiplicative Gaussian white noise, the Stratonovich prescription does not correspond to the well-known midpoint (or any other intermediate) prescription. By introducing an inertial term in the GLE, we show that the Itô and Stratonovich prescriptions naturally arise depending on two time scales, one induced by the inertial term and the other determined by the jump event. We also show that, when the multiplicative noise is linear in the random variable, one prescription can be made equivalent to the other by a suitable transformation in the jump probability distribution. We apply these results to a recently proposed stochastic model describing the dynamics of primary soil salinization, in which the salt mass balance within the soil root zone requires the analysis of different prescriptions arising from the resulting stochastic differential equation forced by multiplicative white Poisson noise, the features of which are tailored to the characters of the daily precipitation. A method is finally suggested to infer the most appropriate prescription from the data.

Prescription-induced jump distributions in multiplicative Poisson processes

Science.gov (United States)

Suweis, Samir; Porporato, Amilcare; Rinaldo, Andrea; Maritan, Amos

2011-06-01

Generalized Langevin equations (GLE) with multiplicative white Poisson noise pose the usual prescription dilemma leading to different evolution equations (master equations) for the probability distribution. Contrary to the case of multiplicative Gaussian white noise, the Stratonovich prescription does not correspond to the well-known midpoint (or any other intermediate) prescription. By introducing an inertial term in the GLE, we show that the Itô and Stratonovich prescriptions naturally arise depending on two time scales, one induced by the inertial term and the other determined by the jump event. We also show that, when the multiplicative noise is linear in the random variable, one prescription can be made equivalent to the other by a suitable transformation in the jump probability distribution. We apply these results to a recently proposed stochastic model describing the dynamics of primary soil salinization, in which the salt mass balance within the soil root zone requires the analysis of different prescriptions arising from the resulting stochastic differential equation forced by multiplicative white Poisson noise, the features of which are tailored to the characters of the daily precipitation. A method is finally suggested to infer the most appropriate prescription from the data.

Habitability of super-Earth planets around other suns: models including Red Giant Branch evolution.

Science.gov (United States)

von Bloh, W; Cuntz, M; Schröder, K-P; Bounama, C; Franck, S

2009-01-01

The unexpected diversity of exoplanets includes a growing number of super-Earth planets, i.e., exoplanets with masses of up to several Earth masses and a similar chemical and mineralogical composition as Earth. We present a thermal evolution model for a 10 Earth-mass planet orbiting a star like the Sun. Our model is based on the integrated system approach, which describes the photosynthetic biomass production and takes into account a variety of climatological, biogeochemical, and geodynamical processes. This allows us to identify a so-called photosynthesis-sustaining habitable zone (pHZ), as determined by the limits of biological productivity on the planetary surface. Our model considers solar evolution during the main-sequence stage and along the Red Giant Branch as described by the most recent solar model. We obtain a large set of solutions consistent with the principal possibility of life. The highest likelihood of habitability is found for "water worlds." Only mass-rich water worlds are able to realize pHZ-type habitability beyond the stellar main sequence on the Red Giant Branch.

Proceedings of the Astrobiology Science Conference 2010. Evolution and Life: Surviving Catastrophes and Extremes on Earth and Beyond

Science.gov (United States)

2010-01-01

The Program of the 2010 Astrobiology Science Conference: Evolution and Life: Surviving Catastrophes and Extremes on Earth and Beyond, included sessions on: 50 Years of Exobiology and Astrobiology: Greatest Hits; Extraterrestrial Molecular Evolution and Pre-Biological Chemistry: From the Interstellar Medium to the Solar System I; Human Exploration, Astronaut Health; Diversity in Astrobiology Research and Education; Titan: Past, Present, and Future; Energy Flow in Microbial Ecosystems; Extraterrestrial Molecular Evolution and Prebiological Chemistry: From the Interstellar Medium to the Solar System II; Astrobiology in Orbit; Astrobiology and Interdisciplinary Communication; Science from Rio Tinto: An Acidic Environment; Can We Rule Out Spontaneous Generation of RNA as the Key Step in the Origin of Life?; How Hellish Was the Hadean Earth?; Results from ASTEP and Other Astrobiology Field Campaigns I; Prebiotic Evolution: From Chemistry to Life I; Adaptation of Life in Hostile Space Environments; Extrasolar Terrestrial Planets I: Formation and Composition; Collaborative Tools and Technology for Astrobiology; Results from ASTEP and Other Astrobiology Field Campaigns II; Prebiotic Evolution: From Chemistry to Life II; Survival, Growth, and Evolution of Microrganisms in Model Extraterrestrial Environments; Extrasolar Terrestrial Planets II: Habitability and Life; Planetary Science Decadal Survey Update; Astrobiology Research Funding; Bioessential Elements Through Space and Time I; State of the Art in Life Detection; Terrestrial Evolution: Implications for the Past, Present, and Future of Life on Earth; Psychrophiles and Polar Environments; Life in Volcanic Environments: On Earth and Beyond; Geochronology and Astrobiology On and Off the Earth; Bioessential Elements Through Space and Time II; Origins and Evolution of Genetic Systems; Evolution of Advanced Life; Water-rich Asteroids and Moons: Composition and Astrobiological Potential; Impact Events and Evolution; A Warm, Wet

Biological Evolution and the History of the Earth Are Foundations of Science

Science.gov (United States)

2008-01-01

AGU affirms the central importance of including scientific theories of Earth history and biological evolution in science education. Within the scientific community, the theory of biological evolution is not controversial, nor have ``alternative explanations'' been found. This is why no competing theories are required by the U.S. National Science Education Standards. Explanations of natural phenomena that appeal to the supernatural or are based on religious doctrine-and therefore cannot be tested through scientific inquiry-are not scientific, and have no place in the science classroom.

THERMAL EVOLUTION AND LIFETIME OF INTRINSIC MAGNETIC FIELDS OF SUPER-EARTHS IN HABITABLE ZONES

International Nuclear Information System (INIS)

Tachinami, C.; Ida, S.; Senshu, H.

2011-01-01

We have numerically studied the thermal evolution of different-mass terrestrial planets in habitable zones, focusing on the duration of dynamo activity to generate their intrinsic magnetic fields, which may be one of the key factors in habitability of the planets. In particular, we are concerned with super-Earths, observations of which are rapidly developing. We calculated the evolution of temperature distributions in the planetary interior using Vinet equations of state, the Arrhenius-type formula for mantle viscosity, and the astrophysical mixing-length theory for convective heat transfer modified for mantle convection. After calibrating the model with terrestrial planets in the solar system, we apply it for 0.1-10 M + rocky planets with a surface temperature of 300 K (in habitable zones) and Earth-like compositions. With the criterion of heat flux at the core-mantle boundary (CMB), the lifetime of the magnetic fields is evaluated from the calculated thermal evolution. We found that the lifetime slowly increases with planetary mass (M p ), independent of the initial temperature gap at the CMB (ΔT CMB ), but beyond the critical value M c,p (∼O(1) M + ) it abruptly declines from the mantle viscosity enhancement due to the pressure effect. We derived M c,p as a function of ΔT CMB and a rheological parameter (activation volume, V*). Thus, the magnetic field lifetime of super-Earths with M p >M p,c sensitively depends on ΔT CMB , which reflects planetary accretion, and V*, which has uncertainty at very high pressure. More advanced high-pressure experiments and first-principle simulation, as well as planetary accretion simulation, are needed to discuss the habitability of super-Earths.

Evolution and dynamics of Earth from a molten initial stage

Science.gov (United States)

Louro Lourenço, D. J.; Tackley, P.

2016-12-01

It is now well established that most of the terrestrial planets underwent a magma ocean stage during their accretion. On Earth, it is probable that at the end of accretion, giant impacts like the hypothesised Moon-forming impact, together with other sources of heat, melted a substantial part of the mantle. The thermal and chemical evolution of the resulting magma ocean most certainly had dramatic consequences on the history of the planet. Considerable research has been done on magma oceans using simple 1-D models (e.g.: Abe, PEPI 1997; Solomatov, Treat. Geophys. 2007; Elkins-Tanton EPSL 2008). However, some aspects of the dynamics may not be adequately addressed in 1-D and require the use of 2-D or 3-D models. Moreover, new developments in mineral physics that indicate that melt can be denser than solid at high pressures (e.g.: de Koker et al., EPSL 2013) can have very important impacts on the classical views of the solidification of magma oceans (Labrosse et al., Nature 2007; Labrosse et al., The Early Earth 2015). The goal of our study is to understand and characterize the influence of melting on the long-term thermo-chemical evolution of rocky planet interiors, starting from an initial molten state (magma ocean). Our approach is to model viscous creep of the solid mantle, while parameterizing processes that involve melt as previously done in 1-D models, including melt-solid separation at all melt fractions, the use of an effective diffusivity to parameterize turbulent mixing, coupling to a parameterized core heat balance and a radiative surface boundary condition. These enhancements have been made to the numerical code StagYY (Tackley, PEPI 2008). We present results for the evolution of an Earth-like planet from a molten initial state to present day, while testing the effect of uncertainties in parameters such as melt-solid density differences, surface heat loss and efficiency of turbulent mixing. Our results show rapid cooling and crystallization until the

Evolution of Earth-like Extrasolar Planetary Atmospheres: Assessing the Atmospheres and Biospheres of Early Earth Analog Planets with a Coupled Atmosphere Biogeochemical Model.

Science.gov (United States)

Gebauer, S; Grenfell, J L; Stock, J W; Lehmann, R; Godolt, M; von Paris, P; Rauer, H

2017-01-01

Understanding the evolution of Earth and potentially habitable Earth-like worlds is essential to fathom our origin in the Universe. The search for Earth-like planets in the habitable zone and investigation of their atmospheres with climate and photochemical models is a central focus in exoplanetary science. Taking the evolution of Earth as a reference for Earth-like planets, a central scientific goal is to understand what the interactions were between atmosphere, geology, and biology on early Earth. The Great Oxidation Event in Earth's history was certainly caused by their interplay, but the origin and controlling processes of this occurrence are not well understood, the study of which will require interdisciplinary, coupled models. In this work, we present results from our newly developed Coupled Atmosphere Biogeochemistry model in which atmospheric O 2 concentrations are fixed to values inferred by geological evidence. Applying a unique tool (Pathway Analysis Program), ours is the first quantitative analysis of catalytic cycles that governed O 2 in early Earth's atmosphere near the Great Oxidation Event. Complicated oxidation pathways play a key role in destroying O 2 , whereas in the upper atmosphere, most O 2 is formed abiotically via CO 2 photolysis. The O 2 bistability found by Goldblatt et al. ( 2006 ) is not observed in our calculations likely due to our detailed CH 4 oxidation scheme. We calculate increased CH 4 with increasing O 2 during the Great Oxidation Event. For a given atmospheric surface flux, different atmospheric states are possible; however, the net primary productivity of the biosphere that produces O 2 is unique. Mixing, CH 4 fluxes, ocean solubility, and mantle/crust properties strongly affect net primary productivity and surface O 2 fluxes. Regarding exoplanets, different "states" of O 2 could exist for similar biomass output. Strong geological activity could lead to false negatives for life (since our analysis suggests that reducing gases

On the Effects of the Evolution of Microbial Mats and Land Plants on the Earth as a Planet. Photometric and Spectroscopic Light Curves of Paleo-Earths

Science.gov (United States)

Sanromá, E.; Pallé, E.; García Munõz, A.

2013-04-01

Understanding the spectral and photometric variability of the Earth and the rest of the solar system planets has become of utmost importance for the future characterization of rocky exoplanets. As this is not only interesting at present times but also along the planetary evolution, we studied the effect that the evolution of microbial mats and plants over land has had on the way our planet looks from afar. As life evolved, continental surfaces changed gradually and non-uniformly from deserts through microbial mats to land plants, modifying the reflective properties of the ground and most likely the distribution of moisture and cloudiness. Here, we used a radiative transfer model of the Earth, together with geological paleo-records of the continental distribution and a reconstructed cloud distribution, to simulate the visible and near-IR radiation reflected by our planet as a function of Earth's rotation. We found that the evolution from deserts to microbial mats and to land plants produces detectable changes in the globally averaged Earth's reflectance. The variability of each surface type is located in different bands and can induce reflectance changes of up to 40% in period of hours. We conclude that by using photometric observations of an Earth-like planet at different photometric bands it would be possible to discriminate between different surface types. While recent literature proposes the red-edge feature of vegetation near 0.7 μm as a signature for land plants, observations in near-IR bands can be equally or even better suited for this purpose.

ON THE EFFECTS OF THE EVOLUTION OF MICROBIAL MATS AND LAND PLANTS ON THE EARTH AS A PLANET. PHOTOMETRIC AND SPECTROSCOPIC LIGHT CURVES OF PALEO-EARTHS

International Nuclear Information System (INIS)

Sanromá, E.; Pallé, E.; García Munõz, A.

2013-01-01

Understanding the spectral and photometric variability of the Earth and the rest of the solar system planets has become of utmost importance for the future characterization of rocky exoplanets. As this is not only interesting at present times but also along the planetary evolution, we studied the effect that the evolution of microbial mats and plants over land has had on the way our planet looks from afar. As life evolved, continental surfaces changed gradually and non-uniformly from deserts through microbial mats to land plants, modifying the reflective properties of the ground and most likely the distribution of moisture and cloudiness. Here, we used a radiative transfer model of the Earth, together with geological paleo-records of the continental distribution and a reconstructed cloud distribution, to simulate the visible and near-IR radiation reflected by our planet as a function of Earth's rotation. We found that the evolution from deserts to microbial mats and to land plants produces detectable changes in the globally averaged Earth's reflectance. The variability of each surface type is located in different bands and can induce reflectance changes of up to 40% in period of hours. We conclude that by using photometric observations of an Earth-like planet at different photometric bands it would be possible to discriminate between different surface types. While recent literature proposes the red-edge feature of vegetation near 0.7 μm as a signature for land plants, observations in near-IR bands can be equally or even better suited for this purpose.

Evolution of NASA's Earth Science Digital Object Identifier Registration System

Science.gov (United States)

Wanchoo, Lalit; James, Nathan

2017-01-01

NASA's Earth Science Data and Information System (ESDIS) Project has implemented a fully automated system for assigning Digital Object Identifiers (DOIs) to Earth Science data products being managed by its network of 12 distributed active archive centers (DAACs). A key factor in the successful evolution of the DOI registration system over last 7 years has been the incorporation of community input from three focus groups under the NASA's Earth Science Data System Working Group (ESDSWG). These groups were largely composed of DOI submitters and data curators from the 12 data centers serving the user communities of various science disciplines. The suggestions from these groups were formulated into recommendations for ESDIS consideration and implementation. The ESDIS DOI registration system has evolved to be fully functional with over 5,000 publicly accessible DOIs and over 200 DOIs being held in reserve status until the information required for registration is obtained. The goal is to assign DOIs to the entire 8000+ data collections under ESDIS management via its network of discipline-oriented data centers. DOIs make it easier for researchers to discover and use earth science data and they enable users to provide valid citations for the data they use in research. Also for the researcher wishing to reproduce the results presented in science publications, the DOI can be used to locate the exact data or data products being cited.

The naked planet Earth: Most essential pre-requisite for the origin and evolution of life

Directory of Open Access Journals (Sweden)

S. Maruyama

2013-03-01

To satisfy the tight conditions to make the Earth habitable, the formation mechanism of primordial Earth is an important factor. At first, a ‘dry Earth’ must be made through giant impact, followed by magma ocean to float nutrient-enriched primordial continents (anorthosite + KREEP. Late bombardment from asteroid belt supplied water to make 3–5 km thick ocean, and not from icy meteorites from Kuiper belt beyond cool Jupiter. It was essential to meet the above conditions that enabled the Earth as a habitable planet with evolved life forms. The tight constraints that we evaluate for birth and evolution of life on Earth would provide important guidelines for planetary scientists hunting for life in the exo-solar planets.

Formation and evolution of plasmoid and flux-rope in the Earth's Magnetotail

Science.gov (United States)

Ge, Yasong; Raeder, Joachim

2015-04-01

The observation of plasmoids and flux-ropes in the Earth's magnetotail was crucial to establish the simultaneous presence of multiple x-lines in the tail, and has become the basis for the Near Earth Neutral Line (NENL) model of substorms. While the "classical" NENL model envisions x-lines that extend across the entire tail, recent observations have shown that neither do the x-lines and resulting plasmoids encompass the entire tail, nor do the x-lines have to lie along the y-axis. The fragmentation of the tail by spatially and temporally limited x-lines has important consequences for the mass and energy budget of the tail. Recent ARTEMIS observations have shown that the plasmoids in the distant tail are limited in the Y direction and some flux ropes are tilted during their tailward propagation. Understanding their formation and evolution during their propagation through the magnetotail shall shred more light on the general energy and flux transport of the Earth's magnetosphere. In this study we simulate plasmoids and flux-ropes in the Earth's magnetotail using the Open Global Geospace Circulation Model (OpenGGCM). We investigate the generation mechanisms for tail plasmoids and flux-ropes and their evolution as they propagate in the magnetotail. The simulation results show that the limited extend of NENL controls the length or the Y scale of tail plasmoid and flux rope. In addition, by studying their 3D magnetic topology we find that the tilted flux rope forms due to a progressive spreading of reconnection line along the east-west direction, which produces and releases two ends of the flux rope at different times and in different speeds. By constructing a catalogue of observational signatures of plasmoid and flux rope we compare the differences of their signatures and find that large-scale plasmoids have much weaker core fields than that inside the small-scale flux ropes.

Evolution of the Earth Observing System (EOS) Data and Information System (EOSDIS)

Science.gov (United States)

Ramapriyan, Hampapuram K.; Behnke, Jeanne; Sofinowski, Edwin; Lowe, Dawn; Esfandiari, Mary Ann

2008-01-01

One of the strategic goals of the U.S. National Aeronautics and Space Administration (NASA) is to "Develop a balanced overall program of science, exploration, and aeronautics consistent with the redirection of the human spaceflight program to focus on exploration". An important sub-goal of this goal is to "Study Earth from space to advance scientific understanding and meet societal needs." NASA meets this subgoal in partnership with other U.S. agencies and international organizations through its Earth science program. A major component of NASA s Earth science program is the Earth Observing System (EOS). The EOS program was started in 1990 with the primary purpose of modeling global climate change. This program consists of a set of space-borne instruments, science teams, and a data system. The instruments are designed to obtain highly accurate, frequent and global measurements of geophysical properties of land, oceans and atmosphere. The science teams are responsible for designing the instruments as well as scientific algorithms to derive information from the instrument measurements. The data system, called the EOS Data and Information System (EOSDIS), produces data products using those algorithms as well as archives and distributes such products. The first of the EOS instruments were launched in November 1997 on the Japanese satellite called the Tropical Rainfall Measuring Mission (TRMM) and the last, on the U.S. satellite Aura, were launched in July 2004. The instrument science teams have been active since the inception of the program in 1990 and have participation from Brazil, Canada, France, Japan, Netherlands, United Kingdom and U.S. The development of EOSDIS was initiated in 1990, and this data system has been serving the user community since 1994. The purpose of this chapter is to discuss the history and evolution of EOSDIS since its beginnings to the present and indicate how it continues to evolve into the future. this chapter is organized as follows. Sect

Microbes, Mineral Evolution, and the Rise of Microcontinents-Origin and Coevolution of Life with Early Earth.

Science.gov (United States)

Grosch, Eugene G; Hazen, Robert M

2015-10-01

Earth is the most mineralogically diverse planet in our solar system, the direct consequence of a coevolving geosphere and biosphere. We consider the possibility that a microbial biosphere originated and thrived in the early Hadean-Archean Earth subseafloor environment, with fundamental consequences for the complex evolution and habitability of our planet. In this hypothesis paper, we explore possible venues for the origin of life and the direct consequences of microbially mediated, low-temperature hydrothermal alteration of the early oceanic lithosphere. We hypothesize that subsurface fluid-rock-microbe interactions resulted in more efficient hydration of the early oceanic crust, which in turn promoted bulk melting to produce the first evolved fragments of felsic crust. These evolved magmas most likely included sialic or tonalitic sheets, felsic volcaniclastics, and minor rhyolitic intrusions emplaced in an Iceland-type extensional setting as the earliest microcontinents. With the further development of proto-tectonic processes, these buoyant felsic crustal fragments formed the nucleus of intra-oceanic tonalite-trondhjemite-granitoid (TTG) island arcs. Thus microbes, by facilitating extensive hydrothermal alteration of the earliest oceanic crust through bioalteration, promoted mineral diversification and may have been early architects of surface environments and microcontinents on young Earth. We explore how the possible onset of subseafloor fluid-rock-microbe interactions on early Earth accelerated metavolcanic clay mineral formation, crustal melting, and subsequent metamorphic mineral evolution. We also consider environmental factors supporting this earliest step in geosphere-biosphere coevolution and the implications for habitability and mineral evolution on other rocky planets, such as Mars.

Role of radon and its progeny in the origin and evolution of life on earth

International Nuclear Information System (INIS)

Subba Ramu, M.C.; Vohra, K.G.

1980-01-01

The role of natural ionising radiations from radon and its progeny in catalysing certain chemical reactions and aiding certain biological phenomena leading to the formation and evolution of life on earth is explained with illustrations. (M.G.B.)

Earth's structure and evolution inferred from topography, gravity, and seismicity.

Science.gov (United States)

Watkinson, A. J.; Menard, J.; Patton, R. L.

2016-12-01

Earth's wavelength-dependent response to loading, reflected in observed topography, gravity, and seismicity, can be interpreted in terms of a stack of layers under the assumption of transverse isotropy. The theory of plate tectonics holds that the outermost layers of this stack are mobile, produced at oceanic ridges, and consumed at subduction zones. Their toroidal motions are generally consistent with those of several rigid bodies, except in the world's active mountain belts where strains are partitioned and preserved in tectonite fabrics. Even portions of the oceanic lithosphere exhibit non-rigid behavior. Earth's gravity-topography cross-spectrum exhibits notable variations in signal amplitude and character at spherical harmonic degrees l=13, 116, 416, and 1389. Corresponding Cartesian wavelengths are approximately equal to the respective thicknesses of Earth's mantle, continental mantle lithosphere, oceanic thermal lithosphere, and continental crust, all known from seismology. Regional variations in seismic moment release with depth, derived from the global Centroid Moment Tensor catalog, are also evident in the crust and mantle lithosphere. Combined, these observations provide powerful constraints for the structure and evolution of the crust, mantle lithosphere, and mantle as a whole. All that is required is a dynamically consistent mechanism relating wavelength to layer thickness and shear-strain localization. A statistically-invariant 'diharmonic' relation exhibiting these properties appears as the leading order approximation to toroidal motions on a self-gravitating body of differential grade-2 material. We use this relation, specifically its predictions of weakness and rigidity, and of folding and shear banding response as a function of wavelength-to-thickness ratio, to interpret Earth's gravity, topography, and seismicity in four-dimensions. We find the mantle lithosphere to be about 255-km thick beneath the Himalaya and the Andes, and the long

Spectra of Earth-like Planets through Geological Evolution around FGKM Stars

Science.gov (United States)

Rugheimer, S.; Kaltenegger, L.

2018-02-01

Future observations of terrestrial exoplanet atmospheres will occur for planets at different stages of geological evolution. We expect to observe a wide variety of atmospheres and planets with alternative evolutionary paths, with some planets resembling Earth at different epochs. For an Earth-like atmospheric time trajectory, we simulate planets from the prebiotic to the current atmosphere based on geological data. We use a stellar grid F0V to M8V ({T}{eff}=7000–2400 K) to model four geological epochs of Earth's history corresponding to a prebiotic world (3.9 Ga), the rise of oxygen at 2.0 Ga and at 0.8 Ga, and the modern Earth. We show the VIS–IR spectral features, with a focus on biosignatures through geological time for this grid of Sun-like host stars and the effect of clouds on their spectra. We find that the observability of biosignature gases reduces with increasing cloud cover and increases with planetary age. The observability of the visible O2 feature for lower concentrations will partly depend on clouds, which, while slightly reducing the feature, increase the overall reflectivity, and thus the detectable flux of a planet. The depth of the IR ozone feature contributes substantially to the opacity at lower oxygen concentrations, especially for the high near-UV stellar environments around F stars. Our results are a grid of model spectra for atmospheres representative of Earth's geological history to inform future observations and instrument design and are available online at http://carlsaganinstitute.org/data/.

A Novel Theory For The Origin And Evolution Of Stars And Planets, Including Earth, Which Asks, 'Was The Earth Once A Small Bright Star?'

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Cimorelli, S. A.; Samuels, C.

2001-12-01

Improved prediction methods for earthquakes and volcanic activity will naturally follow from our theory, based on new concepts of the earth's interior composition, state and activity. In this paper we present a novel hypothesis for the formation and evolution of galaxies, stars (including black holes (BHs), neutron stars, giant, mid-size, dwarf, dying and dead stars), planets (including earth), and moons. Present day phenomenon will be used to substantiate the validity of this hypothesis. Every `body' is a multiple type of star, generated from modified pieces called particle proliferators, of a dislodged/expanded BH (of category 2 (c-2)) which explodes due to a collision with another expanded BH (or explodes on its own). This includes the sun, and the planet earth, which is a type of dead star. Such that, if we remove layers of the earth, starting with the crust, we will find evidence of each preceding star formation, from brown to blue, and the remains of the particle proliferator as the innermost core is reached. We show that the hypothesis is consistent with both the available astronomical data regarding stellar evolution and planetary formation; as well as the evolution of the earth itself, by considerations of the available geophysical data. Where data is not available, reasonably simple experiments are suggested to demonstrate further the consistency and viability of the hypothesis. Theories are presented to help define and explain phenomenon such as how two (or more) c-2 BHs expand and collide to form a small `big bang' (It is postulated that there was a small big bang to form each galaxy, similar to the big bang from a category 1 BH(s) that may have formed our universe. The Great Attractors would be massive c-2 BHs and act on galaxy clusters similar to the massive c-3 BHs at the center of Galaxies acting on stars.). This in turn afforded the material/matter to form all the galactic bodies, including the dark matter inside the galaxies that we catalogue as

THE INFLUENCE OF PRESSURE-DEPENDENT VISCOSITY ON THE THERMAL EVOLUTION OF SUPER-EARTHS

International Nuclear Information System (INIS)

Stamenković, Vlada; Noack, Lena; Spohn, Tilman; Breuer, Doris

2012-01-01

We study the thermal evolution of super-Earths with a one-dimensional (1D) parameterized convection model that has been adopted to account for a strong pressure dependence of the viscosity. A comparison with a 2D spherical convection model shows that the derived parameterization satisfactorily represents the main characteristics of the thermal evolution of massive rocky planets. We find that the pressure dependence of the viscosity strongly influences the thermal evolution of super-Earths—resulting in a highly sluggish convection regime in the lower mantles of those planets. Depending on the effective activation volume and for cooler initial conditions, we observe with growing planetary mass even the formation of a conductive lid above the core-mantle boundary (CMB), a so-called CMB-lid. For initially molten planets our results suggest no CMB-lids but instead a hot lower mantle and core as well as sluggish lower mantle convection. This implies that the initial interior temperatures, especially in the lower mantle, become crucial for the thermal evolution—the thermostat effect suggested to regulate the interior temperatures in terrestrial planets does not work for massive planets if the viscosity is strongly pressure dependent. The sluggish convection and the potential formation of the CMB-lid reduce the convective vigor throughout the mantle, thereby affecting convective stresses, lithospheric thicknesses, and heat fluxes. The pressure dependence of the viscosity may therefore also strongly affect the propensity of plate tectonics, volcanic activity, and the generation of a magnetic field of super-Earths.

Virtual Exploration of Earth's Evolution

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Anbar, A. D.; Bruce, G.; Semken, S. C.; Summons, R. E.; Buxner, S.; Horodyskyj, L.; Kotrc, B.; Swann, J.; Klug Boonstra, S. L.; Oliver, C.

2014-12-01

Traditional introductory STEM courses often reinforce misconceptions because the large scale of many classes forces a structured, lecture-centric model of teaching that emphasizes delivery of facts rather than exploration, inquiry, and scientific reasoning. This problem is especially acute in teaching about the co-evolution of Earth and life, where classroom learning and textbook teaching are far removed from the immersive and affective aspects of field-based science, and where the challenges of taking large numbers of students into the field make it difficult to expose them to the complex context of the geologic record. We are exploring the potential of digital technologies and online delivery to address this challenge, using immersive and engaging virtual environments that are more like games than like lectures, grounded in active learning, and deliverable at scale via the internet. The goal is to invert the traditional lecture-centric paradigm by placing lectures at the periphery and inquiry-driven, integrative virtual investigations at the center, and to do so at scale. To this end, we are applying a technology platform we devised, supported by NASA and the NSF, that integrates a variety of digital media in a format that we call an immersive virtual field trip (iVFT). In iVFTs, students engage directly with virtual representations of real field sites, with which they interact non-linearly at a variety of scales via game-like exploration while guided by an adaptive tutoring system. This platform has already been used to develop pilot iVFTs useful in teaching anthropology, archeology, ecology, and geoscience. With support the Howard Hughes Medical Institute, we are now developing and evaluating a coherent suite of ~ 12 iVFTs that span the sweep of life's history on Earth, from the 3.8 Ga metasediments of West Greenland to ancient hominid sites in East Africa. These iVFTs will teach fundamental principles of geology and practices of scientific inquiry, and expose

Tidal Heating of Earth-like Exoplanets around M Stars: Thermal, Magnetic, and Orbital Evolutions.

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Driscoll, P E; Barnes, R

2015-09-01

The internal thermal and magnetic evolution of rocky exoplanets is critical to their habitability. We focus on the thermal-orbital evolution of Earth-mass planets around low-mass M stars whose radiative habitable zone overlaps with the "tidal zone," where tidal dissipation is expected to be a significant heat source in the interior. We develop a thermal-orbital evolution model calibrated to Earth that couples tidal dissipation, with a temperature-dependent Maxwell rheology, to orbital circularization and migration. We illustrate thermal-orbital steady states where surface heat flow is balanced by tidal dissipation and cooling can be stalled for billions of years until circularization occurs. Orbital energy dissipated as tidal heat in the interior drives both inward migration and circularization, with a circularization time that is inversely proportional to the dissipation rate. We identify a peak in the internal dissipation rate as the mantle passes through a viscoelastic state at mantle temperatures near 1800 K. Planets orbiting a 0.1 solar-mass star within 0.07 AU circularize before 10 Gyr, independent of initial eccentricity. Once circular, these planets cool monotonically and maintain dynamos similar to that of Earth. Planets forced into eccentric orbits can experience a super-cooling of the core and rapid core solidification, inhibiting dynamo action for planets in the habitable zone. We find that tidal heating is insignificant in the habitable zone around 0.45 (or larger) solar-mass stars because tidal dissipation is a stronger function of orbital distance than stellar mass, and the habitable zone is farther from larger stars. Suppression of the planetary magnetic field exposes the atmosphere to stellar wind erosion and the surface to harmful radiation. In addition to weak magnetic fields, massive melt eruption rates and prolonged magma oceans may render eccentric planets in the habitable zone of low-mass stars inhospitable for life.

HOW THERMAL EVOLUTION AND MASS-LOSS SCULPT POPULATIONS OF SUPER-EARTHS AND SUB-NEPTUNES: APPLICATION TO THE KEPLER-11 SYSTEM AND BEYOND

International Nuclear Information System (INIS)

Lopez, Eric D.; Miller, Neil; Fortney, Jonathan J.

2012-01-01

We use models of thermal evolution and extreme ultraviolet (XUV) driven mass loss to explore the composition and history of low-mass, low-density transiting planets. We investigate the Kepler-11 system in detail and provide estimates of both the current and past planetary compositions. We find that an H/He envelope on Kepler-11b is highly vulnerable to mass loss. By comparing to formation models, we show that in situ formation of the system is extremely difficult. Instead we propose that it is a water-rich system of sub-Neptunes that migrated from beyond the snow line. For the broader population of observed planets, we show that there is a threshold in bulk planet density and incident flux above which no low-mass transiting planets have been observed. We suggest that this threshold is due to the instability of H/He envelopes to XUV-driven mass loss. Importantly, we find that this mass-loss threshold is well reproduced by our thermal evolution/contraction models that incorporate a standard mass-loss prescription. Treating the planets' contraction history is essential because the planets have significantly larger radii during the early era of high XUV fluxes. Over time low-mass planets with H/He envelopes can be transformed into water-dominated worlds with steam envelopes or rocky super-Earths. Finally, we use this threshold to provide likely minimum masses and radial-velocity amplitudes for the general population of Kepler candidates. Likewise, we use this threshold to provide constraints on the maximum radii of low-mass planets found by radial-velocity surveys.

On the Tidal Evolution of the Earth-Moon System: A Cosmological Model

Directory of Open Access Journals (Sweden)

Arbab A. I.

2009-01-01

Full Text Available We have presented a cosmological model for the tidal evolution of the Earth-Moon system. We have found that the expansion of the universe has immense consequences on our local systems. The model can be compared with the present observational data. The close approach problem inflicting the known tidal theory is averted in this model. We have also shown that the astronomical and geological changes of our local systems are of the order of Hubble constant.

Insights into recent and ancient trends in the co-evolution of Earth and life as revealed by microbial genomics

Science.gov (United States)

Anderson, R. E.; Huber, J. A.; Parsons, C.; Stüeken, E.

2017-12-01

Since the origin of life over 4 billion years ago, life has fundamentally altered the habitability of Earth. Similarly, the environment molds the evolutionary trajectory of life itself through natural selection. Microbial genomes retain a "memory" of the co-evolution of life and Earth and can be analyzed to better understand trends and events in both the recent and distant past. To examine evolutionary trends in the more recent past, we have used metagenomics analyses to investigate which environmental factors play the strongest role in driving the evolution of microbes in deep-sea hydrothermal vents, which are thought to have been important habitats in the earliest stages of life's evolution. We have shown that microbial populations in a deep, basalt-hosted system appear to be under stronger purifying selection than populations inhabiting a cooler serpentinizing system less than 20 km away, suggesting that environmental context and geochemistry have an important impact on evolutionary rates and trends. We also found evidence that viruses play an important role in driving evolution in these habitats. Changing environmental conditions may also effect long-term evolutionary trends in Earth's distant past, as revealed by comparative genomics. By reconciling phylogenetic trees for microbial species with trees of metabolic genes, we can determine approximately when crucial metabolic genes began to spread across the tree of life through horizontal gene transfer. Using these methods, we conducted an analysis of the relative timing of the spread of genes related to the nitrogen cycle. Our results indicate that the rate of horizontal gene transfer for important genes related to denitrification increased after the Great Oxidation Event, concurrent with geochemical evidence for increasing availability of nitrate, suggesting that the oxygenation of the atmosphere and surface ocean may have been an important determining factor for the spread of denitrification genes across the

On the asymmetric evolution of the perihelion distances of near-Earth Jupiter family comets around the discovery time

Science.gov (United States)

Sosa, A.; Fernández, J. A.; Pais, P.

2012-12-01

We study the dynamical evolution of the near-Earth Jupiter family comets (NEJFCs) that came close to or crossed the Earth's orbit at the epoch of their discovery (perihelion distances qdisc time evolution of the mean perihelion distance bar{q} of the NEJFCs at the discovery time of each comet (taken as t = 0) and a past-future asymmetry of bar{q} in an interval -1000 yr, +1000 yr centred on t = 0, confirming previous results. The asymmetry indicates that there are more comets with greater q in the past than in the future. For comparison purposes, we also analysed the population of near-Earth asteroids in cometary orbits (defined as those with aphelion distances Q > 4.5 AU) and with absolute magnitudes H time a large sample of fictitious comets, cloned from the observed NEJFCs, over a 20 000 yr time interval and started the integration before the comet's discovery time, when it had a perihelion distance q > 2 AU. By assuming that NEJFCs are mostly discovered when they decrease their perihelion distances below a certain threshold qthre = 1.05 AU for the first time during their evolution, we were able to reproduce the main features of the observed bar{q} evolution in the interval [-1000, 1000] yr with respect to the discovery time. Our best fits indicate that 40% of the population of NEJFCs would be composed of young, fresh comets that entered the region q spending at least 3000 yr in the q family comets (JFCs).

Nitrogen evolution within the Earth's atmosphere-mantle system assessed by recycling in subduction zones

Science.gov (United States)

Mallik, Ananya; Li, Yuan; Wiedenbeck, Michael

2018-01-01

Understanding the evolution of nitrogen (N) across Earth's history requires a comprehensive understanding of N's behaviour in the Earth's mantle - a massive reservoir of this volatile element. Investigation of terrestrial N systematics also requires assessment of its evolution in the Earth's atmosphere, especially to constrain the N content of the Archaean atmosphere, which potentially impacted water retention on the post-accretion Earth, potentially causing enough warming of surface temperatures for liquid water to exist. We estimated the proportion of recycled N in the Earth's mantle today, the isotopic composition of the primitive mantle, and the N content of the Archaean atmosphere based on the recycling rates of N in modern-day subduction zones. We have constrained recycling rates in modern-day subduction zones by focusing on the mechanism and efficiency of N transfer from the subducting slab to the sub-arc mantle by both aqueous fluids and slab partial melts. We also address the transfer of N by aqueous fluids as per the model of Li and Keppler (2014). For slab partial melts, we constrained the transfer of N in two ways - firstly, by an experimental study of the solubility limit of N in melt (which provides an upper estimate of N uptake by slab partial melts) and, secondly, by the partitioning of N between the slab and its partial melt. Globally, 45-74% of N introduced into the mantle by subduction enters the deep mantle past the arc magmatism filter, after taking into account the loss of N from the mantle by degassing at mid-ocean ridges, ocean islands and back-arcs. Although the majority of the N in the present-day mantle remains of primordial origin, our results point to a significant, albeit minor proportion of mantle N that is of recycled origin (17 ± 8% or 12 ± 5% of N in the present-day mantle has undergone recycling assuming that modern-style subduction was initiated 4 or 3 billion years ago, respectively). This proportion of recycled N is enough to

On the effects of the evolution of microbial mats and land plants on the Earth as a planet. Photometric and spectroscopic light curves of paleo-Earths

OpenAIRE

Sanromá, E.; Pallé, E.; García-Muñoz, A.

2013-01-01

Understanding the spectral and photometric variability of the Earth and the rest of the solar system planets has become of the utmost importance for the future characterization of rocky exoplanets. As this is not only interesting at present times but also along the planetary evolution, we studied the effect that the evolution of microbial mats and plants over land has had on the way our planet looks from afar. As life evolved, continental surfaces changed gradually and non- uniformly from des...

Hot Spots in the Earth's Crust. Crustal Evolution Education Project. Teacher's Guide [and] Student Investigation.

Science.gov (United States)

Stoever, Edward C., Jr.

Crustal Evolution Education Project (CEEP) modules were designed to: (1) provide students with the methods and results of continuing investigations into the composition, history, and processes of the earth's crust and the application of this knowledge to man's activities and (2) to be used by teachers with little or no previous background in the…

Substance use - prescription drugs

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Substance use disorder - prescription drugs; Substance abuse - prescription drugs; Drug abuse - prescription drugs; Drug use - prescription drugs; Narcotics - substance use; Opioid - substance use; Sedative - substance ...

Global simulation of formation and evolution of plasmoid and flux-rope in the Earth's Magnetotail

Science.gov (United States)

Ge, Y.; Raeder, J.; Du, A.

2014-12-01

The observation of plasmoids and flux-ropes in the Earth's magnetotail was crucial to establish the simultaneous presence of multiple x-lines in the tail, and has become the basis for the Near Earth Neutral Line (NENL) model of substorms. While the "classical" NENL model envisions x-lines that extend across the entire tail, recent observations have shown that neither do the x-lines and resulting plasmoids encompass the entire tail, nor do the x-lines have to lie along the y-axis. The fragmentation of the tail by spatially and temporally limited x-lines has important consequences for the mass and energy budget of the tail. Recent ARTEMIS observations have shown that the plasmoids in the distant tail are limited in the Y direction and some flux ropes are tilted during their tailward propagation. Understanding their formation and evolution during their propagation through the magnetotail shall shred more light on the general energy and flux transport of the Earth's magnetosphere. In this study we simulate plasmoids and flux-ropes in the Earth's magnetotail using the Open Global Geospace Circulation Model (OpenGGCM). We investigate the generation mechanisms for tail plasmoids and flux-ropes and their evolution as they propagate in the magnetotail. The simulation results show that the limited extend of NENL controls the length or the Y scale of tail plasmoid and flux rope. In addition, by studying their 3D magnetic topology we find that the tilted flux rope forms due to a progressive spreading of reconnection line along the east-west direction, which produces and releases two ends of the flux rope at different times and in different speeds. By constructing a catalogue of observational signatures of plasmoid and flux rope we compare the differences of their signatures and find that large-scale plasmoids have much weaker core fields than that inside the small-scale flux ropes.

Early evolution and dynamics of Earth from a molten initial stage

Science.gov (United States)

Louro Lourenço, Diogo; Tackley, Paul J.

2016-04-01

It is now well established that most of the terrestrial planets underwent a magma ocean stage during their accretion. On Earth, it is probable that at the end of accretion, giant impacts like the hypothesised Moon-forming impact, together with other sources of heat, melted a substantial part of the mantle. The thermal and chemical evolution of the resulting magma ocean most certainly had dramatic consequences on the history of the planet. Considerable research has been done on magma oceans using simple 1-D models (e.g.: Abe, PEPI 1997; Solomatov, Treat. Geophys. 2007; Elkins-Tanton EPSL 2008). However, some aspects of the dynamics may not be adequately addressed in 1-D and require the use of 2-D or 3-D models. Moreover, new developments in mineral physics that indicate that melt can be denser than solid at high pressures (e.g.: de Koker et al., EPSL 2013) can have very important impacts on the classical views of the solidification of magma oceans (Labrosse et al., Nature 2007). The goal of our study is to understand and characterize the influence of melting on the long-term thermo-chemical evolution of rocky planet interiors, starting from an initial molten state (magma ocean). Our approach is to model viscous creep of the solid mantle, while parameterizing processes that involve melt as previously done in 1-D models, including melt-solid separation at all melt fractions, the use of an effective diffusivity to parameterize turbulent mixing, coupling to a parameterized core heat balance and a radiative surface boundary condition. These enhancements have been made to the numerical code StagYY (Tackley, PEPI 2008). We present results for the evolution of an Earth-like planet from a molten initial state to present day, while testing the effect of uncertainties in parameters such as melt-solid density differences, surface heat loss and efficiency of turbulent mixing. Our results show rapid cooling and crystallization until the rheological transition then much slower

Prescription Drug Abuse

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... drug abuse. And it's illegal, just like taking street drugs. Why Do People Abuse Prescription Drugs? Some people abuse prescription drugs ... common risk of prescription drug abuse is addiction . People who abuse ... as if they were taking street drugs. That's one reason most doctors won't ...

Earth Evolution and Dynamics (Arthur Holmes Medal Lecture)

Science.gov (United States)

Torsvik, Trond H.

2016-04-01

While physicists are fantasizing about a unified theory that can explain just about everything from subatomic particles (quantum mechanics) to the origin of the Universe (general relativity), Darwin already in 1858 elegantly unified the biological sciences with one grand vision. In the Earth Sciences, the description of the movement and deformation of the Earth's outer layer has evolved from Continental Drift (1912) into Sea-Floor Spreading (1962) and then to the paradigm of Plate Tectonics in the mid-to-late 1960s. Plate Tectonics has been extremely successful in providing a framework for understanding deformation and volcanism at plate boundaries, allowed us to understand how continent motions through time are a natural result of heat escaping from Earth's deep interior, and has granted us the means to conduct earthquake and volcanic hazard assessments and hydrocarbon exploration, which have proven indispensable for modern society. Plate Tectonics is as fundamentally unifying to the Earth Sciences as Darwin's Theory of Evolution is to the Life Sciences, but it is an incomplete theory that lacks a clear explanation of how plate tectonics, mantle convection and mantle plumes interact. Over the past decade, however, we have provided compelling evidence that plumes rise from explicit plume generation zones at the margins of two equatorial and antipodal large low shear-wave velocity provinces (Tuzo and Jason). These thermochemical provinces on the core-mantle boundary have been stable for at least the last 300 million years, possibly the last 540 million years, and their edges are the dominant sources of the plumes that generate large igneous provinces, hotspots and kimberlites. Linking surface and lithospheric processes to the mantle is extremely challenging and is only now becoming feasible due to breakthroughs in the estimation of ancient longitudes before the Cretaceous, greatly improved seismic tomography, recent advances in mineral physics, and new developments

NASA's Earth Observing System Data and Information System - Many Mechanisms for On-Going Evolution

Science.gov (United States)

Ramapriyan, H. K.

2012-12-01

NASA's Earth Observing System Data and Information System has been serving a broad user community since August 1994. As a long-lived multi-mission system serving multiple scientific disciplines and a diverse user community, EOSDIS has been evolving continuously. It has had and continues to have many forms of community input to help with this evolution. Early in its history, it had inputs from the EOSDIS Advisory Panel, benefited from the reviews by various external committees and evolved into the present distributed architecture with discipline-based Distributed Active Archive Centers (DAACs), Science Investigator-led Processing Systems and a cross-DAAC search and data access capability. EOSDIS evolution has been helped by advances in computer technology, moving from an initially planned supercomputing environment to SGI workstations to Linux Clusters for computation and from near-line archives of robotic silos with tape cassettes to RAID-disk-based on-line archives for storage. The network capacities have increased steadily over the years making delivery of data on media almost obsolete. The advances in information systems technologies have been having an even greater impact on the evolution of EOSDIS. In the early days, the advent of the World Wide Web came as a game-changer in the operation of EOSDIS. The metadata model developed for the EOSDIS Core System for representing metadata from EOS standard data products has had an influence on the Federal Geographic Data Committee's metadata content standard and the ISO metadata standards. The influence works both ways. As ISO 19115 metadata standard has developed in recent years, EOSDIS is reviewing its metadata to ensure compliance with the standard. Improvements have been made in the cross-DAAC search and access of data using the centralized metadata clearing house (EOS Clearing House - ECHO) and the client Reverb. Given the diversity of the Earth science disciplines served by the DAACs, the DAACs have developed a

Evolution of NASA's Near-Earth Tracking and Data Relay Satellite System (TDRSS)

Science.gov (United States)

Flaherty, Roger; Stocklin, Frank; Weinberg, Aaron

2006-01-01

orbit, including dedicated science missions and lunar support/cargo vehicles; earth/moon transit; lunar in-situ operations; and other missions within approximately 2 million km of earth (e.g., at the sun/earth libration points). Given that the NER is an evolution of TDRSS, one element of this NASA-wide architecture development activity is a trade study of future NER architecture candidates. The present paper focuses on trade study aspects associated with the NER, highlights study elements, and provides representative interim results.

Research Reports from the First Pre-ICME Satellite Conference on Diagnostic and Prescriptive Mathematics (Monash University, Melbourne, Australia, August 21-22, 1984).

Science.gov (United States)

Blane, Dudley, Ed.

Provided are the papers presented at a conference which served as an international forum on diagnostic and prescriptive mathematics education. They are: (1) "The Evolution of the Research Council for Diagnostic and Prescriptive Mathematics" by Robert Underhill; (2) "The Interaction of Knowledge and Cognitive Processes in Diagnosis…

Evolution of the Earth and Origin of Life: The Role of Gas/Fluid Interactions with Rocks

Science.gov (United States)

Freund, Friedemann

2001-01-01

The work under the Cooperative Agreement will be centered on questions of the evolution of Life on the early Earth and possibly on Mars. It is still hotly debated whether the essential organic molecules were delivered to the early Earth from space (by comets, meteorites or interplanetary dust particles) or were generated in situ on Earth. Prior work that has shown that the matrix of igneous minerals is a medium in which progenitors of organic molecules assemble from H2O, C02 and N2 incorporated as minority "impurities" in minerals of igneous rocks during crystallization from H2O/CO2/N2-laden magmas. The underlying processes involve a redox. conversion whereby C, H, and N become chemically reduced, while 0 becomes oxidized to the peroxy state. During Year 02 the work will be divided into three tasks. Task 1: After carboxylic (fatty) acids and N-bearing compounds have been identified, other extractable organic molecules including lipids, oily substances and amino acids will be studied. Dedicated lipid analysis will be combined with gas chromatographic-mass spectroscopic (GCMS) analysis of organic compounds extracted from minerals and rocks. Task 2: Using infrared (IR) spectroscopy, C-H entities that are indicators for the organic progenitors in mineral matrices will be studied. A preliminary heating experiment with MgO single crystals has shown that the C-H entities can be pyrolyzed, causing the IR bands to disappear, but at room temperature the IR bands reappear in a matter of days to weeks. This work will be expanded, both by studying synthetic MgO crystals and olivine crystals from the Earth's upper mantle. The C-H bands will be compared to the published "organic" IR feature of dust in the interstellar medium (ISM) and interplanetary dust particles (IDP). Task 3: A paradox marks the evolution of early Life: Oxygen is highly toxic to primitive life, yet early organisms "learned" to detoxify reactive oxygen species, to utilize oxygen, and even produce it. Why would

Partnership for Prescription Assistance

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... may use our name without our permission. The Partnership for Prescription Assistance will help you find the ... Events Blog Facebook Twitter Start living better. The Partnership for Prescription Assistance helps qualifying patients without prescription ...

Water and the Earth System in the Anthropocene: Evolution of Socio-Hydrology

Science.gov (United States)

Sivapalan, M.; Bloeschl, G.

2014-12-01

Over the past century, hydrological science has evolved through distinct eras as judged by ideas, information sources, technological advances and societal influences: Empirical Era which was data based with little theory, Systems Era that focused on input-output relationships, Process Era with a focus on processes, and the Geosciences Era where hydrology was considered an Earth System science. We argue that as the human footprint on earth becomes increasingly dominant, we are moving into a Co-evolution Era. Co-evolution implies that the components of the Earth system are intimately intertwined at many time scales - fast scales of immediate feedbacks that translate into slow scale interdependencies and trends. These involve feedbacks between the atmosphere, biota, soils and landforms, mediated by water flow and transport processes. The human factor is becoming a key component of this coupled system. While there is a long tradition of considering effects of water on humans, and vice versa, the new thrust on socio-hydrology has a number of defining characteristics that sets it apart from traditional approaches: - Capturing feedbacks of human-natural water system in a dynamic way (slow and fast processes) to go beyond prescribing human factors as mere boundary conditions. These feedbacks will be essential to understand how the system may evolve in the future into new, perhaps previously unobserved, states. - Quantifying system dynamics in a generalizable way. So far, water resources assessment has been context dependent, tied to local conditions. While for immediate decision making this is undoubtedly essential, for more scientific inquiry, a more uniform knowledge base is indispensable. - Not necessarily predictive. The coupled human-nature system is inherently non-linear, which may prohibit predictability in the traditional sense. The socio-hydrologic approach may still be predictive in a statistical sense and, perhaps even more importantly, it may yet reveal

Exercise Dosing and Prescription-Playing It Safe: Dangers and Prescription.

Science.gov (United States)

Wang, Lei; Ai, Dongmei; Zhang, Ning

2017-01-01

Cardiac rehabilitation is a comprehensive and multidisciplinary program, and exercise training is extremely crucial in the whole program. In the past decades, many researches have shown the beneficial effects of exercise for cardiovascular disease (CVD) is indisputable Nevertheless, only a well-designed exercise prescription may achieve the ideal benefits. In this chapter, we will have a discussion of what is exercise prescription and how to establish a scientific and appropriate exercise prescription for CVD patients depending on the current scientific evidence and recommendations.

Lead-lead systematics, the 'age of the earth' and the chemical evolution of our planet in a new representation space

International Nuclear Information System (INIS)

Manhes, G.; Allegre, C.J.; Dupre, B.; Hamelin, B.

1979-01-01

A new way to look at the Pb-Pb isotopic results is proposed. The characteristics are as follows: (1) knowledge of the initial ratios of cogenetic samples is not necessary to discuss the isotopic evolution of parent bodies; and (2) linear representations are permissible thus allowing for a simplified treatment in comparison to the classical 206 Pb/ 204 Pb vs. 207 Pb/ 204 Pb diagram. Using Pb-Pb data of terrestrial samples, either stated in past reasearch or as recently measured by the laboratory, problems such as the Earth's age and its evolution are being dealt with utilising this new formalism. The treatment for a set of mantle whole-rock measurements, assuming only the initial isotopic composition furnishes a value for the Earth's age of 4.49 +- 0.17 b.y. (Auth.)

Isotopic evolution of the protoplanetary disk and the building blocks of Earth and the Moon

Science.gov (United States)

Schiller, Martin; Bizzarro, Martin; Fernandes, Vera Assis

2018-03-01

Nucleosynthetic isotope variability among Solar System objects is often used to probe the genetic relationship between meteorite groups and the rocky planets (Mercury, Venus, Earth and Mars), which, in turn, may provide insights into the building blocks of the Earth–Moon system. Using this approach, it has been inferred that no primitive meteorite matches the terrestrial composition and the protoplanetary disk material from which Earth and the Moon accreted is therefore largely unconstrained. This conclusion, however, is based on the assumption that the observed nucleosynthetic variability of inner-Solar-System objects predominantly reflects spatial heterogeneity. Here we use the isotopic composition of the refractory element calcium to show that the nucleosynthetic variability in the inner Solar System primarily reflects a rapid change in the mass-independent calcium isotope composition of protoplanetary disk solids associated with early mass accretion to the proto-Sun. We measure the mass-independent 48Ca/44Ca ratios of samples originating from the parent bodies of ureilite and angrite meteorites, as well as from Vesta, Mars and Earth, and find that they are positively correlated with the masses of their parent asteroids and planets, which are a proxy of their accretion timescales. This correlation implies a secular evolution of the bulk calcium isotope composition of the protoplanetary disk in the terrestrial planet-forming region. Individual chondrules from ordinary chondrites formed within one million years of the collapse of the proto-Sun reveal the full range of inner-Solar-System mass-independent 48Ca/44Ca ratios, indicating a rapid change in the composition of the material of the protoplanetary disk. We infer that this secular evolution reflects admixing of pristine outer-Solar-System material into the thermally processed inner protoplanetary disk associated with the accretion of mass to the proto-Sun. The identical calcium isotope composition of Earth

[Transparent evolution of the energy/matter interactions on earth: from gas whirlwind to technogenic civilization].

Science.gov (United States)

Pechurkin, N S; Shuvaev, A N

2015-01-01

The paper presents the idea of transparent evolution through the long-term reaction of the planet Earth on the external flow of radiant energy from the Sun. Due to limitations of matter on Earth, as well as on any other planet, the continuous pumping flow of radiant energy was shown to lead to cyclization and transport of substance on emerging gradients. The evolution of energy-matter interaction follows the path of capturing and transferring more energy by the fewer matter, i.e., the path of growth of the amount of energy used by each unit mass. For this indicator, the least effective mass transfer is a simple mass transfer as vortices of gases, in the gradients of temperature and pressure, which occurred on the primary surface of the planet. A long-term natural selection related to the accumulation of water on the planet has played a special role in developing the interaction of energy and matter. Phase transformations (ice, water, vapor) and mechanical transfers are the most common energy-matter processes. Based on water cycles, cyclic transports and transformations, chemical transformation of substances became possible developing over time into a biological transformation. This kind of the interaction of energy and matter is most efficient. In particular, during photosynthesis the energy of our star "is captured and utilized" in the most active part of the spectrum of its radiation. In the process of biological evolution of heterotrophs, a rise (by a factor of hundreds) in the coefficient that characterizes the intensity of energy exchange from protozoa to mammals is most illustratory. The development and the current dominance of humans as the most energy-using active species in capturing the energy and meaningful organization of its new flows especially on the basis of organic debris of former biospheres is admirable, but quite natural from the energy positions. In the course of technological evolution of humankind, the measure of the intensity of energy for

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

Science.gov (United States)

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

2009-05-13

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

Prescription Opioid Usage and Abuse Relationships: An Evaluation of State Prescription Drug Monitoring Program Efficacy

Directory of Open Access Journals (Sweden)

Richard M. Reisman

2009-01-01

Full Text Available Context The dramatic rise in the use of prescription opioids to treat non-cancer pain has been paralleled by increasing prescription opioid abuse. However, detailed analyses of these trends and programs to address them are lacking. Objective To study the association between state shipments of prescription opioids for medical use and prescription opioid abuse admissions and to assess the effects of state prescription drug monitoring programs (PDMPs on prescription opioid abuse admissions. Design and Setting A retrospective ecological cohort study comparing state prescription opioid shipments (source: Automation of Reports and Consolidated Orders Systems database and inpatient admissions for prescription opioid abuse (source: Treatment Episode Data Set in 14 states with PDMPs (intervention group and 36 states without PDMPs (control group for the period 1997–2003. Results From 1997 to 2003, oxycodone, morphine, and hydrocodone shipments increased by 479%, 100%, and 148% respectively. Increasing prescription oxycodone shipments were significantly associated with increasing prescription opioid admission rates (p < 0.001. PDMP states had significantly lower oxycodone shipments than the control group. PDMP states had less increase in prescription opioid admissions per year (p = 0.063. A patient admitted to an inpatient drug abuse rehabilitation program in a PDMP state was less likely to be admitted for prescription opioid drug abuse (Odds ratio = 0.775, 95% Confidence Interval 0.764–0.785. Conclusions PDMPs appear to decrease the quantity of oxycodone shipments and the prescription opioid admission rate for states with these programs. Overall, opioid shipments rose significantly in PDMP states during the study period indicating a negligible “chilling effect” on physician prescribing.

A simple way to improve AGN feedback prescription in SPH simulations

Science.gov (United States)

Zubovas, Kastytis; Bourne, Martin A.; Nayakshin, Sergei

2016-03-01

Active galactic nuclei (AGN) feedback is an important ingredient in galaxy evolution, however its treatment in numerical simulations is necessarily approximate, requiring subgrid prescriptions due to the dynamical range involved in the calculations. We present a suite of smoothed particle hydrodynamics simulations designed to showcase the importance of the choice of a particular subgrid prescription for AGN feedback. We concentrate on two approaches to treating wide-angle AGN outflows: thermal feedback, where thermal and kinetic energy is injected into the gas surrounding the supermassive black hole (SMBH) particle, and virtual particle feedback, where energy is carried by tracer particles radially away from the AGN. We show that the latter model produces a far more complex structure around the SMBH, which we argue is a more physically correct outcome. We suggest a simple improvement to the thermal feedback model - injecting the energy into a cone, rather than spherically symmetrically - and show that this markedly improves the agreement between the two prescriptions, without requiring any noticeable increase in the computational cost of the simulation.

Jupiter and planet Earth

International Nuclear Information System (INIS)

1975-01-01

The evolution of Jupiter and Earth are discussed along with their atmospheres, the radiation belts around both planets, natural satellites, the evolution of life, and the Pioneer 10. Educational study projects are also included

Prescription Drug Abuse

Science.gov (United States)

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

Isotopes and the early evolution of the earth

International Nuclear Information System (INIS)

Russell, R.D.

1980-01-01

The observed isotopic ratios of lead, strontium, neodymium, helium, and argon contain information about the chemical abundances of selected parent and daughter elements in the outer parts of the Earth. By necessity, we observe these isotopic ratios at the Earth's surface, which is a small, highly evolved part of the Earth. The studies of such isotopic ratios permit inferences to be made about interactions between this crust and the upper mantle. Helium has been especially valuable for demonstrating that primordial materials are still being outgassed from the earth. Models based on the observed argon isotopic ratios have lead to contradictory conclusions about the existence of an early period of extensive outgassing of the Earth. Lead has been a particularly interesting element because the ratio of the parents, 235 U/ 238 U, was very different in the Earth's early history than it is now. Therefore there is the potential for determining constraints on the early history of the Earth. A number of recently published papers offering lead isotope interpretations that reflect on the Earth's early history are reviewed, with special reference to models that are based upon uni-directional and bi-directional exchange between a protocrust and a residual mantle. Geochemical parameters for uranium, thorium and lead can be inferred for two evolving systems, as well as rate constants for differentiation. The principal conclusions are that the differentiation process extended beyond the first quarter of the Earth's history, and that it is possible to reproduce exactly the apparent oceanic basalt isochron by a simple two-reservoir model. In particular, such a model can explain quantitatively the observed lead-207 deficiency in the oceanic basalts

Looking at prescription quality in Ayurveda: Developing, validating and pilot testing a prescription quality index for Ayurveda.

Science.gov (United States)

Rastogi, Sanjeev

2017-11-06

Prescription quality can be a direct predictor of the net outcome of a health care delivery effort. Quality of prescription may be considered as a cumulative matrix of multiple components of a prescription on the basis of their relative importance. Prescription quality index is a recognized tool in clinical medicine for multiple purposes including the prediction of health care intervention outcome. Considering the importance of prescription quality among every system of medicine, an attempt was made to design a prescription quality index for Ayurveda. The Prescription Quality Index for Ayurveda was designed through item selection following a thorough literature search and was validated through multiple peer group discussions. Final draft of index containing 38 individual items carrying different scores as per their importance in the prescription was subjected to a pilot test upon 1576 indoor prescriptions generated in 2015 at State Ayurvedic College Hospital, Lucknow. The study revealed large information gaps in the components of the prescription where it was supposed to be noted by the prescribers. These gaps in the Ayurvedic prescriptions were most significant in the areas pertaining to Ayurvedic fundamentals of clinical examination, disease diagnosis and Ayurvedic drug intake methods. Prescription Quality Index for Ayurveda was found useful in underlining the gaps between the ideal and generated prescriptions. This can be utilized as a useful tool to evaluate the quality of Ayurvedic prescriptions by seeing their adherence to the standard prescription template. Copyright © 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

[Changes in prescription patterns for peripheral and cerebral vasoactive drugs before and after establishing prescription standards in France].

Science.gov (United States)

Vuittenez, F; Guignard, E; Comte, S

1999-01-23

Assess changes in the number of prescriptions for peripheral and cerebral vasoactive drugs for the treatment of lower limb arteritis and cerebrovascular disease since the promulgation in 1995 of prescription standards for the treatment of lower limb arteritis. Assess compliance to prescription standards with a detailed analysis of patient features, prescriptions written for lower limb arteritis, cerebrovascular disease and concomitant diseases and evaluate changes in treatment costs for lower limb arteritis and cerebrovascular disease as well as cost of the full prescription, including treatments for associated diseases. This study was based on data recorded during the Permanent Study of Medical Prescriptions conducted from March 1994 to February 1995 and from March 1995 to February 1996 by the IMS. Prescription costs were established from the National Description Files of the IMS. Treatment costs were expressed as public price (FF) tax included. Prescriptions meeting the following criteria were selected for each period: prescriptions written by general practitioners for drugs with peripheral and cerebral vasoactivity (excepting calcium antagonists with a cerebral target) belonging to the Anatomic Therapeutic Classes C4A1 of the European Pharmaceutical Marketing Research Association, Bromly 1996; prescriptions for diagnoses 447.6 (arteritis) and 437.9 (cerebrovascular disease) according to the 9th WHO classification. A random sample of 500 prescriptions was selected to calculate costs. Since the advent of the prescription standards in 1995, prescriptions have dropped off by 6.3% for lower limb arteritis and by 14.8% for cerebrovascular disease. There was a 3.7 point decline in the percentage of multiple prescriptions of vasoactive drugs for lower limb arteritis (21.7% prior to March 1995 versus 18% after promulgation of the prescription standards, p > 0.1) and a 1.8 increase in the percentage of multiple prescriptions for cerebrovascular disease (14% prior to March

Prescriptions for schedule II opioids and benzodiazepines increase after the introduction of computer-generated prescriptions.

Science.gov (United States)

McGerald, Genevieve; Dvorkin, Ronald; Levy, David; Lovell-Rose, Stephanie; Sharma, Adhi

2009-06-01

Prescriptions for controlled substances decrease when regulatory barriers are put in place. The converse has not been studied. The objective was to determine whether a less complicated prescription writing process is associated with a change in the prescribing patterns of controlled substances in the emergency department (ED). The authors conducted a retrospective nonconcurrent cohort study of all patients seen in an adult ED between April 19, 2005, and April 18, 2007, who were discharged with a prescription. Prior to April 19, 2006, a specialized prescription form stored in a locked cabinet was obtained from the nursing staff to write a prescription for benzodiazepines or Schedule II opioids. After April 19, 2006, New York State mandated that all prescriptions, regardless of schedule classification, be generated on a specialized bar-coded prescription form. The main outcome of the study was to compare the proportion of Schedule III-V opioids to Schedule II opioids and benzodiazepines prescribed in the ED before and after the introduction of a less cumbersome prescription writing process. Of the 26,638 charts reviewed, 2.1% of the total number of prescriptions generated were for a Schedule II controlled opioid before the new system was implemented compared to 13.6% after (odds ratio [OR] = 7.3, 95% confidence interval [CI] = 6.4 to 8.4). The corresponding percentages for Schedule III-V opioids were 29.9% to 18.1% (OR = 0.52, 95% CI = 0.49 to 0.55) and for benzodiazepines 1.4% to 3.9% (OR = 2.8, 95% CI = 2.4 to 3.4). Patients were more likely to receive a prescription for a Schedule II opioid or a benzodiazepine after a more streamlined computer-generated prescription writing process was introduced in this ED. (c) 2009 by the Society for Academic Emergency Medicine.

Prescription drug coupons: evolution and need for regulation in direct-to-consumer advertising.

Science.gov (United States)

Mackey, Tim K; Yagi, Nozomi; Liang, Bryan A

2014-01-01

Pharmaceutical marketing in the United States had undergone a shift from largely exclusively targeting physicians to considerable efforts in targeting patients through various forms of direct-to-consumer advertising ("DTCA"). This includes the use of DTCA in prescription drug coupons ("PDCs"), a new form of DTCA that offers discounts and rebates directly to consumers to lower costs of drug purchasing. Our examination of PDCs reveals that the use and types of PDC programs is expanding and includes promotion of the vast majority of top grossing pharmaceuticals. However, controversy regarding this emerging form of DTCA has given rise to health policy concerns about their overall impact on prescription drug expenditures for consumers, payers, and the health care system, and whether they lead to optimal long-term utilization of pharmaceuticals. In response to these concerns and the growing popularity of PDCs, what we propose here are clearer regulation and regulatory guidance for PDC DTCA use. This would include review for appropriate disclosure of marketing claims, increased transparency in PDC use for pharmaceutical pricing, and leveraging potential positive benefits of PDC use for vulnerable or underserved patient populations. Copyright © 2014 Elsevier Inc. All rights reserved.

A prescription fraud detection model.

Science.gov (United States)

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

2012-04-01

Prescription fraud is a main problem that causes substantial monetary loss in health care systems. We aimed to develop a model for detecting cases of prescription fraud and test it on real world data from a large multi-center medical prescription database. Conventionally, prescription fraud detection is conducted on random samples by human experts. However, the samples might be misleading and manual detection is costly. We propose a novel distance based on data-mining approach for assessing the fraudulent risk of prescriptions regarding cross-features. Final tests have been conducted on adult cardiac surgery database. The results obtained from experiments reveal that the proposed model works considerably well with a true positive rate of 77.4% and a false positive rate of 6% for the fraudulent medical prescriptions. The proposed model has the potential advantages including on-line risk prediction for prescription fraud, off-line analysis of high-risk prescriptions by human experts, and self-learning ability by regular updates of the integrative data sets. We conclude that incorporating such a system in health authorities, social security agencies and insurance companies would improve efficiency of internal review to ensure compliance with the law, and radically decrease human-expert auditing costs. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Evolution of Information Management at the GSFC Earth Sciences (GES) Data and Information Services Center (DISC): 2006-2007

Science.gov (United States)

Kempler, Steven; Lynnes, Christopher; Vollmer, Bruce; Alcott, Gary; Berrick, Stephen

2009-01-01

Increasingly sophisticated National Aeronautics and Space Administration (NASA) Earth science missions have driven their associated data and data management systems from providing simple point-to-point archiving and retrieval to performing user-responsive distributed multisensor information extraction. To fully maximize the use of remote-sensor-generated Earth science data, NASA recognized the need for data systems that provide data access and manipulation capabilities responsive to research brought forth by advancing scientific analysis and the need to maximize the use and usability of the data. The decision by NASA to purposely evolve the Earth Observing System Data and Information System (EOSDIS) at the Goddard Space Flight Center (GSFC) Earth Sciences (GES) Data and Information Services Center (DISC) and other information management facilities was timely and appropriate. The GES DISC evolution was focused on replacing the EOSDIS Core System (ECS) by reusing the In-house developed disk-based Simple, Scalable, Script-based Science Product Archive (S4PA) data management system and migrating data to the disk archives. Transition was completed in December 2007

Evolution of the Stability Work from Classic Retaining Walls to Mechanically Stabilized Earth Walls

Directory of Open Access Journals (Sweden)

Anghel Stanciu

2008-01-01

Full Text Available For the consolidation of soil mass and the construction of the stability works for roads infrastructure it was studied the evolution of these kinds of works from classical retaining walls - common concrete retaining walls, to the utilization in our days of the modern and competitive methods - mechanically stabilized earth walls. Like type of execution the variety of the reinforced soil is given by the utilization of different types of reinforcing inclusions (steel strips, geosynthetics, geogrids or facing (precast concrete panels, dry cast modular blocks, metal sheets and plates, gabions, and wrapped sheets of geosynthetics.

Analytic model for the long-term evolution of circular Earth satellite orbits including lunar node regression

Science.gov (United States)

Zhu, Ting-Lei; Zhao, Chang-Yin; Zhang, Ming-Jiang

2017-04-01

This paper aims to obtain an analytic approximation to the evolution of circular orbits governed by the Earth's J2 and the luni-solar gravitational perturbations. Assuming that the lunar orbital plane coincides with the ecliptic plane, Allan and Cook (Proc. R. Soc. A, Math. Phys. Eng. Sci. 280(1380):97, 1964) derived an analytic solution to the orbital plane evolution of circular orbits. Using their result as an intermediate solution, we establish an approximate analytic model with lunar orbital inclination and its node regression be taken into account. Finally, an approximate analytic expression is derived, which is accurate compared to the numerical results except for the resonant cases when the period of the reference orbit approximately equals the integer multiples (especially 1 or 2 times) of lunar node regression period.

Schrodinger Evolution for the Universe: Reparametrization

OpenAIRE

Gryb, Sean; Thebault, Karim

2015-01-01

Starting from a generalized Hamilton-Jacobi formalism, we develop a new framework for constructing observables and their evolution in theories invariant under global time reparametrizations. Our proposal relaxes the usual Dirac prescription for the observables of a totally constrained system (`perennials') and allows one to recover the influential partial and complete observables approach in a particular limit. Difficulties such as the non-unitary evolution of the complete observables in term...

Continental growth and mantle hydration as intertwined feedback cycles in the thermal evolution of Earth

Science.gov (United States)

Höning, Dennis; Spohn, Tilman

2016-06-01

A model of Earth's continental coverage and mantle water budget is discussed along with its thermal evolution. The model links a thermal evolution model based on parameterized mantle convection with a model of a generic subduction zone that includes the oceanic crust and a sedimentary layer as carriers of water. Part of the subducted water is used to produce continental crust while the remainder is subducted into the mantle. The total length of the subduction zones is calculated from the total surface area of continental crust assuming randomly distributed continents. The mantle viscosity is dependent of temperature and the water concentration. Sediments are generated by continental crust erosion, and water outgassing at mid-oceanic ridges closes the water cycle. We discuss the strongly coupled, non-linear model using a phase plane defined by the continental coverage and mantle water concentration. Fixed points are found in the phase plane at which the rates of change of both variables are zero. These fixed points evolve with time, but in many cases, three fixed points emerge of which two are stable and an intermediate point is unstable with respect to continental coverage. With initial conditions from a Monte-Carlo scheme we calculate evolution paths in the phase plane and find a large spread of final states that all have a mostly balanced water budget. The present day observed 40% continental surface coverage is found near the unstable fixed point. Our evolution model suggests that Earth's continental coverage formed early and has been stable for at least 1.5 Gyr. The effect of mantle water regassing (and mantle viscosity depending on water concentration) is found to lower the present day mantle temperature by about 120 K, but the present day mantle viscosity is affected little. The water cycle thus complements the well-known thermostat effect of viscosity and mantle temperature. Our results further suggest that the biosphere could impact the feedback cycles by

Visualization of medicine prescription behavior

NARCIS (Netherlands)

Corput, van der P.N.A.; Arends, J.B.A.M.; Wijk, van J.J.

2014-01-01

Medicine prescriptions play an important role in medical treatments. More insight in medicine prescription behavior can lead to more efficient and effective treatments, as well as reflection on prescription behavior for specific physicians, types of medicines, or classes of patients. Most current

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

Science.gov (United States)

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

2016-06-01

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

Early Evolution of Earth's Geochemical Cycle and Biosphere: Implications for Mars Exobiology

Science.gov (United States)

DesMarais, David J.; Chang, Sherwood (Technical Monitor)

1997-01-01

Carbon (C) has played multiple key roles for life and its environment. C has formed organics, greenhouse gases, aquatic pH buffers, redox buffers, and magmatic constituents affecting plutonism and volcanism. These roles interacted across a network of reservoirs and processes known as the biogeochemical C cycle. Changes in the cycle over geologic time were driven by increasing solar luminosity, declining planetary heat flow, and continental and biological evolution. The early Archean C cycle was dominated by hydrothermal alteration of crustal rocks and by thermal emanations of CO2 and reduced species (eg., H2, Fe(2+) and sulfides). Bioorganic synthesis was achieved by nonphotosynthetic CO2-fixing bacteria (chemoautotrophs) and, possibly, bacteria (organotrophs) utilizing any available nonbiological organic C. Responding both to abundant solar energy and to a longterm decline in thermal sources of chemical energy and reducing power, the blaspheme first developed anoxygenic photosynthesis, then, ultimately, oxygenic photosynthesis. O2-photosynthesis played a central role in transforming the ancient environment and blaspheme to the modem world. The geochemical C cycles of early Earth and Mars were quite similar. The principal differences between the modem C cycles of these planets arose during the later evolution of their heat flows, crusts, atmospheres and, perhaps, their blasphemes.

Radiopharmaceutical prescription in nuclear medicine departments

International Nuclear Information System (INIS)

Biechlin-Chassel, M.L.; Lao, S.; Bolot, C.; Francois-Joubert, A.

2010-01-01

In France, radiopharmaceutical prescription is often discussed depending to which juridical structure the nuclear medicine department is belonging. According to current regulation, this prescription is an obligation in a department linked to hospital with a pharmacy department inside. But situation remains unclear for independent nuclear medicine departments where physicians are not constrained to prescribe radiopharmaceuticals. However, as radiographers and nurses are only authorized to realize theirs acts in front of a medical prescription, one prescription must be realized. Nowadays, computerized prescription tools have been developed but only for radiopharmaceutical drugs and not for medical acts. In the aim to achieve a safer patient care, the prescription regulation may be applied whatever differences between nuclear medicines departments. (authors)

Prescription Drug Profiles PUF

Data.gov (United States)

U.S. Department of Health & Human Services — This release contains the Prescription Drug Profiles Public Use Files (PUFs) drawn from Medicare prescription drug claims for the year of the date on which the...

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

Science.gov (United States)

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

2009-07-01

Evidence suggests gender differences in abuse of prescription opioids. This study aimed to describe characteristics of women who abuse prescription opioids in a treatment-seeking sample and to contrast gender differences among prescription opioid abusers. Data collected November 2005 to April 2008 derived from the Addiction Severity Index Multimedia Version Connect (ASI-MV Connect) database. Bivariate and multivariable logistic regression examined correlates of prescription opioid abuse stratified by gender. 29,906 assessments from 220 treatment centers were included, of which 12.8% (N=3821) reported past month prescription opioid abuse. Women were more likely than men to report use of any prescription opioid (29.8% females vs. 21.1% males, phistory of drug overdose. Men-specific correlates were age screen and identify those at highest risk of prescription opioid abuse. Prevention and intervention efforts with a gender-specific approach are warranted.

Formation and evolution of plasmoids and flux-ropes in the Earth's Magnetotail

Science.gov (United States)

Ge, Y.; Raeder, J.

2013-12-01

The observation of plasmoids and flux-ropes in the Earth's magnetotail was crucial to establish the simultaneous presence of multiple x-lines in the tail, and has become the basis for the Near Earth Neutral Line (NENL) model of substorms. While the 'classical' NENL model envisions x-lines that extend across the entire tail, recent observations have shown that neither do the x-lines and resulting plasmoids encompass the entire tail, nor do the x-lines have to lie along the y-axis. Furthermore, several x-line/plasmoid/flux-rope structures can exist simultaneously. The fragmentation of the tail by spatially and temporally limited x-lines has important consequences for the mass and energy budget of the tail. Recent ARTEMIS observations have shown that the plasmoids in the distant tail are limited in the Y direction and some flux ropes are tilted during their tailward propagation. In this study we simulate plasmoids and flux-ropes in the Earth's magnetotail using the Open Global Geospace Circulation Model (OpenGGCM). We investigate the generation mechanisms for tail plasmoids and flux-ropes and their evolution as they propagate in the magnetotail. The simulation results show that the limited extend of NENL controls the length or the Y scale of tail plasmoid and flux rope. In addition, by studying their 3D magnetic topology we find that tilted flux ropes form due to a progressive spreading of the reconnection line along the east-west direction, which produces and releases the two ends of the flux rope at different times and at different speeds. By constructing a catalogue of observational signatures of plasmoid and flux rope we compare the differences of their signatures and find that large-scale plasmoids have much weaker core fields than that found inside the small-scale flux ropes.

[Analysis on composition principles of prescriptions for stranguria in dictionary of traditional Chinese medicine prescription].

Science.gov (United States)

Sun, Jing-Chang; Wang, Miao-Miao

2014-03-01

By using traditional Chinese medicine inheritance support system to analyze the dominant experience and recessive principles of the prescriptions for stranguria in the dictionary of traditional Chinese medicine prescription (DCMP), we aim to define the medication pattern and rule and to acquire new prescriptions. In dominant experience analysis, we were able to find 22 drugs used over 50 times, including drugs of clearing heat, diuresis and relieving stranguria which are the most used and drugs of clearing heat, cooling blood, benefiting Qi and nourishing Yin. In addition, drugs of activating Qi and Xue, eliminating phlegm and removing toxic are often used, including 34 herb pairs and 5 combinations of three-taste drugs are used more than 35 times. These results fully reflect the composition principles and compatibility characteristic of prescriptions for treating stranguria in DCMP. Thirteen new prescriptions by way of recessive principle excavating were acquired. These new prescriptions might be suitable to clinical treatments of variable syndromes. This article provides an useful clue to research and produce new drugs.

Evolution of a Coronal Mass Ejection from the Sun to Mercury, Venus, Earth and Beyond

Science.gov (United States)

Wang, Y.; Shen, C.; Liu, J.; Mengjiao, X.; Guo, J.

2017-12-01

A clear magnetic cloud was observed by Messenger at Mercury. By using coronagraph images from SOHO/LASCO and STEREO/COR and the in-situ data from Wind near the Earth, we estimated its propgation velocity and identified the possible CME candidate in the corona and its counterpart recorded by Venus Express near Venus. By applying the CME's DIPS (Deflection in InterPlanetary Space) model, we show that the CME's arrivals at the three different heliocentric distance can be well reproduced. By extending the trajectory of the CME to the orbitor of Mars, we predict the arrival of the CME at Mars, which is in agreement with a significant Forbush decrease observed by MSL. We use uniformly-twisted force-free flux rope model to fit the in-situ measurements at Mercury, Venus and the Earth to study the evolution of the magnetic flux rope, and find that both axial magnetic flux and twist significantly decreased, suggesting that a significant erosion process was on-going and might change the averaged twist of the magnetic flux rope.

The new PV prescription for IR singularities of NLO splitting functions

International Nuclear Information System (INIS)

Skrzypek, M.; Jadach, S.; Kusina, A.

2014-07-01

In this note we outline the Monte Carlo project KrkMC. The goal of this project is to construct a QCD Parton Shower accurate to NLO level in both coefficient function and splitting function (shower) parts. We discuss in detail one of its aspects - the evolution kernels. The kernels had to be recalculated in a new regularisation scheme, called NPV. In this scheme all the singularities in the plus component of the integration momenta are regularised by means of principal value prescription. This is in contrast to the standard approach, in which only the spurious axial singularities are regularised by principal value. As a result, the triple poles in the dimensional regularisation parameter ε are replaced by a combination of ε-poles and logarithms of geometrical cut-off δ. The resulting exclusive parton densities are more suitable for stochastic applications in four dimensions. Simultaneously, at the inclusive level, the standard and new prescriptions give the same results provided appropriate real and virtual contributions are added.

The evolution of the Earth-Moon system

International Nuclear Information System (INIS)

Finch, D.G.

1982-01-01

The tidally-induced couple acting on the Moon, due to friction between the oceans and their beds, is calculated as a function of the Earth-Moon separation. The function is found to be proportional to 1 +d/R 3 , and not the previously used 1/R 6 . By use of this new function it is found that the present rate of lunar recession gives an acceptable history for the system if it is assumed the Moon was initially in a close geo-stationary orbit 4 billion years ago, when perturbed by the condensation of the Earth's core. (Auth.)

Diagnosis-Prescription in the Context of Instructional Management.

Science.gov (United States)

Besel, Ronald

The usage of the terms "diagnosis" and "prescription" in the fields of medicine and electronic troubleshooting is reviewed, and a common structure for diagnosis-prescription is proposed. The diagnosis-prescription decision sequence is outlined. Prescription-without-diagnosis and diagnosis-without-prescription in education is discussed. The…

Usefulness of traditionally defined herbal properties for distinguishing prescriptions of traditional Chinese medicine from non-prescription recipes.

Science.gov (United States)

Ung, C Y; Li, H; Kong, C Y; Wang, J F; Chen, Y Z

2007-01-03

Traditional Chinese medicine (TCM) has been widely practiced and is considered as an attractive to conventional medicine. Multi-herb recipes have been routinely used in TCM. These have been formulated by using TCM-defined herbal properties (TCM-HPs), the scientific basis of which is unclear. The usefulness of TCM-HPs was evaluated by analyzing the distribution pattern of TCM-HPs of the constituent herbs in 1161 classical TCM prescriptions, which shows patterns of multi-herb correlation. Two artificial intelligence (AI) methods were used to examine whether TCM-HPs are capable of distinguishing TCM prescriptions from non-TCM recipes. Two AI systems were trained and tested by using 1161 TCM prescriptions, 11,202 non-TCM recipes, and two separate evaluation methods. These systems correctly classified 83.1-97.3% of the TCM prescriptions, 90.8-92.3% of the non-TCM recipes. These results suggest that TCM-HPs are capable of separating TCM prescriptions from non-TCM recipes, which are useful for formulating TCM prescriptions and consistent with the expected correlation between TCM-HPs and the physicochemical properties of herbal ingredients responsible for producing the collective pharmacological and other effects of specific TCM prescriptions.

The Landscape Evolution Observatory: a large-scale controllable infrastructure to study coupled Earth-surface processes

Science.gov (United States)

Pangle, Luke A.; DeLong, Stephen B.; Abramson, Nate; Adams, John; Barron-Gafford, Greg A.; Breshears, David D.; Brooks, Paul D.; Chorover, Jon; Dietrich, William E.; Dontsova, Katerina; Durcik, Matej; Espeleta, Javier; Ferré, T.P.A.; Ferriere, Regis; Henderson, Whitney; Hunt, Edward A.; Huxman, Travis E.; Millar, David; Murphy, Brendan; Niu, Guo-Yue; Pavao-Zuckerman, Mitch; Pelletier, Jon D.; Rasmussen, Craig; Ruiz, Joaquin; Saleska, Scott; Schaap, Marcel; Sibayan, Michael; Troch, Peter A.; Tuller, Markus; van Haren, Joost; Zeng, Xubin

2015-01-01

Zero-order drainage basins, and their constituent hillslopes, are the fundamental geomorphic unit comprising much of Earth's uplands. The convergent topography of these landscapes generates spatially variable substrate and moisture content, facilitating biological diversity and influencing how the landscape filters precipitation and sequesters atmospheric carbon dioxide. In light of these significant ecosystem services, refining our understanding of how these functions are affected by landscape evolution, weather variability, and long-term climate change is imperative. In this paper we introduce the Landscape Evolution Observatory (LEO): a large-scale controllable infrastructure consisting of three replicated artificial landscapes (each 330 m2 surface area) within the climate-controlled Biosphere 2 facility in Arizona, USA. At LEO, experimental manipulation of rainfall, air temperature, relative humidity, and wind speed are possible at unprecedented scale. The Landscape Evolution Observatory was designed as a community resource to advance understanding of how topography, physical and chemical properties of soil, and biological communities coevolve, and how this coevolution affects water, carbon, and energy cycles at multiple spatial scales. With well-defined boundary conditions and an extensive network of sensors and samplers, LEO enables an iterative scientific approach that includes numerical model development and virtual experimentation, physical experimentation, data analysis, and model refinement. We plan to engage the broader scientific community through public dissemination of data from LEO, collaborative experimental design, and community-based model development.

A new prescription for soft gluon resummation

International Nuclear Information System (INIS)

Abbate, Riccardo; Forte, Stefano; Ridolfi, Giovanni

2007-01-01

We present a new prescription for the resummation of the divergent series of perturbative corrections, due to soft gluon emission, to hard processes near threshold in perturbative QCD (threshold resummation). This prescription is based on Borel resummation, and contrary to the commonly used minimal prescription, it does not introduce a dependence of resummed physical observables on the kinematically unaccessible x→0 region of parton distributions. We compare results for resummed deep-inelastic scattering obtained using the Borel prescription and the minimal prescription and exploit the comparison to discuss the ambiguities related to the resummation procedure

The Danish National Prescription Registry

DEFF Research Database (Denmark)

Kildemoes, Helle Wallach; Toft Sørensen, Henrik; Hallas, Jesper

2011-01-01

Introduction: Individual-level data on all prescription drugs sold in Danish community pharmacies has since 1994 been recorded in the Register of Medicinal Products Statistics of the Danish Medicines Agency. Content: The register subset, termed the Danish National Prescription Registry (DNPR......), contains information on dispensed prescriptions, including variables at the level of the drug user, the prescriber, and the pharmacy. Validity and coverage: Reimbursement-driven record keeping, with automated bar-code-based data entry provides data of high quality, including detailed information...

Prescription drug abuse: problem, policies, and implications.

Science.gov (United States)

Phillips, Janice

2013-01-01

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

Cyanobacterial evolution during the Precambrian

Science.gov (United States)

Schirrmeister, Bettina E.; Sanchez-Baracaldo, Patricia; Wacey, David

2016-07-01

Life on Earth has existed for at least 3.5 billion years. Yet, relatively little is known of its evolution during the first two billion years, due to the scarceness and generally poor preservation of fossilized biological material. Cyanobacteria, formerly known as blue green algae were among the first crown Eubacteria to evolve and for more than 2.5 billion years they have strongly influenced Earth's biosphere. Being the only organism where oxygenic photosynthesis has originated, they have oxygenated Earth's atmosphere and hydrosphere, triggered the evolution of plants -being ancestral to chloroplasts- and enabled the evolution of complex life based on aerobic respiration. Having such a strong impact on early life, one might expect that the evolutionary success of this group may also have triggered further biosphere changes during early Earth history. However, very little is known about the early evolution of this phylum and ongoing debates about cyanobacterial fossils, biomarkers and molecular clock analyses highlight the difficulties in this field of research. Although phylogenomic analyses have provided promising glimpses into the early evolution of cyanobacteria, estimated divergence ages are often very uncertain, because of vague and insufficient tree-calibrations. Results of molecular clock analyses are intrinsically tied to these prior calibration points, hence improving calibrations will enable more precise divergence time estimations. Here we provide a review of previously described Precambrian microfossils, biomarkers and geochemical markers that inform upon the early evolution of cyanobacteria. Future research in micropalaeontology will require novel analyses and imaging techniques to improve taxonomic affiliation of many Precambrian microfossils. Consequently, a better understanding of early cyanobacterial evolution will not only allow for a more specific calibration of cyanobacterial and eubacterial phylogenies, but also provide new dates for the tree

Alcohol and prescription drug safety in older adults

Directory of Open Access Journals (Sweden)

Zanjani F

2013-02-01

Full Text Available Faika Zanjani,1,2 Aasha I Hoogland,1 Brian G Downer11Department of Gerontology, 2Building Interdisciplinary Research Careers in Women's Health University of Kentucky, Lexington, KY, USABackground: The objectives of this study were to investigate older adults' knowledge of prescription drug safety and interactions with alcohol, and to identify pharmacists' willingness to disseminate prescription drug safety information to older adults.Methods: The convenience sample consisted of 48 older adults aged 54–89 years who were recruited from a local pharmacy and who completed surveys addressing their alcohol consumption, understanding of alcohol and prescription drug interactions, and willingness to change habits regarding alcohol consumption and prescription drugs. To address pharmacist willingness, 90 pharmacists from local pharmacies volunteered and answered questions regarding their willingness to convey prescription drug safety information to older adults.Results: Older adults reported low knowledge of alcohol and prescription drug safety, with women tending to be slightly more knowledgeable. More importantly, those who drank in the previous few months were less willing to talk to family and friends about how alcohol can have harmful interactions with prescription drugs, or to be an advocate for safe alcohol and prescription drug use than those who had not had a drink recently. Pharmacists reported that they were willing to convey prescription drug safety information to older adults via a variety of formats, including displaying or distributing a flyer, and directly administering a brief intervention.Conclusion: In this study, older adults were found to have inadequate knowledge of prescription drug safety and interactions with alcohol, but pharmacists who regularly come in contact with older adults indicated that they were ready and willing to talk to older adults about prescription drug safety. Future research should focus on interventions

Assessment of parental understanding of paediatric medical prescriptions

Directory of Open Access Journals (Sweden)

Sadiqua Anjum, Nasir Mohiuddin M, Narayan Reddy U, Narsing Rao J, Sana Afreen, Mir S Adil, Javeedullah M

2014-07-01

Full Text Available Introduction: Medical prescriptions are bound to be misinterpreted by patients and pharmacists if not properly conveyed. Pediatric prescriptions differ from adult prescriptions having wide variation in doses and formulations. There is a need to evaluate the lacunae in the parental understanding of pediatric prescriptions. Aims and objective: To evaluate the parental understanding of pediatric prescription and to evaluate the adequacy of communication with the physician and pharmacist regarding the same. Material and methods: 550 parents were enrolled and their literacy level was noted. They were subjected to modify MUSE questionnaire. Physician’s prescription was analyzed in terms of ease of understanding by parents. These parents were followed up till the pharmacies and the pharmacist understanding of prescription was analyzed and their communication with parents regarding drug usage was noted. Finally, ease of usage of drugs by parents was noted. Results: MUSE scale was modified to suit pediatric prescription understanding by parents and also additional questions were asked to include complete parental understanding of doctor’s prescription. Majority of parents failed to completely understand the written prescription. Though around 80% of pharmacist could understand the prescription, their communication with parents was poor resulting in difficulty for parents to even enquire about medicines from them. Parental overall understanding of prescription increased with their literacy levels. Conclusion: Not all prescriptions are completely understood by parents as well as a pharmacist. This can lead to misuse of drugs. Efforts to explain the drug usage are not adequate enough from the doctor or the pharmacist. While communicating literacy levels of parents is not being considered which may further worsen the understanding ability

[Drug interactions in chronic prescription].

Science.gov (United States)

Comet, D; Casajuana, J; Bordas, J M; Fuentes, M A; Arnáiz, J A; Núñez, B; Pou, R

1997-06-30

Application of computerized program for detection of potential drug interactions (PDI) in chronic prescriptions in four primary care centers. To evaluate the clinical significance of PDI identified according to clinical criterions. An observational crossover study. Clutat Vella health district (City of Barcelona). Using information of Consejo General de Colegios Oficiales de Farmaceuticos databases and the chronic prescriptions database of the primary care centers, computerized drug-interaction system have been developed for detection of PDI in patients. A panel of primary care physicians and clinical pharmacists developed criteria that were used to evaluate the clinical significance of PDI. 9840 Cards of Authorized Prescription (CAP) were analyzed, 36108 medicaments and 42877 drugs. A total of 2140 patients were involved for a total of 3406 PDI, 21.75% of patients with CAP. Clinical signification for the panel was found in 40.07% of these 3406 PIF; 3.78% were suggest to avoid the association drugs. The incidence of PDI with clinical signification are lower than other studies of the literature; it suggest a appropriate knowledge of drug prescription. The application of computerized program make much more easy the detection of adverse drug interactions in chronic prescription.

Increasing Direct Care Staff Compliance to Individualized Physical Therapy Body Positioning Prescriptions: Prescriptive Checklists.

Science.gov (United States)

Lattimore, Jennifer; And Others

1984-01-01

The study confirmed previous research indicating that workshop training by itself is an ineffective method of increasing direct care staff compliance to treatment prescriptions, and that providing direct staff supervisors with a training and management tool (prescriptive checklists) may be an effective alternative for serving multihandicapped…

[Hospital fluoroquinolone prescription habits in northern France].

Science.gov (United States)

Levent, T; Cabaret, P

2010-09-01

The aim of the study was to assess the good use organization and fluoroquinolone prescription habits in cases of bone and joint, urinary, pulmonary, and digestive infections. A declarative survey was made (questionnaire for the hospital and for the prescriber). Thirty percent (44/145) of hospitals participated with 274 prescribers. Eighty percent had prescription protocols, 71 % of clinicians had access to epidemiologic data. A percentage of 30.7 (853/2,771) of prescriptions included a fluoroquinolone, 44.5 % (380/853) among these had not been recommended. The excessive prescription reached 24.4 % (116/474) in case of bone and joint infection, 14.6 % (107/731), and 20 % (157/779) in cases of digestive and respiratory infection respectively. Prescriptions for urinary infection were adequate in 47.6 % (375/787) of cases. Inadequate prescriptions were made because of bad knowledge of bacteria resistance epidemiology and pharmacology (insufficient dose, monotherapy at risk of selection), and non-application of good practice recommendations. This study justifies the rationalization of antibiotic prescription. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

[Analysis on traditional Chinese medicine prescriptions treating cancer based on traditional Chinese medicine inheritance assistance system and discovery of new prescriptions].

Science.gov (United States)

Yu, Ming; Cao, Qi-chen; Su, Yu-xi; Sui, Xin; Yang, Hong-jun; Huang, Lu-qi; Wang, Wen-ping

2015-08-01

Malignant tumor is one of the main causes for death in the world at present as well as a major disease seriously harming human health and life and restricting the social and economic development. There are many kinds of reports about traditional Chinese medicine patent prescriptions, empirical prescriptions and self-made prescriptions treating cancer, and prescription rules were often analyzed based on medication frequency. Such methods were applicable for discovering dominant experience but hard to have an innovative discovery and knowledge. In this paper, based on the traditional Chinese medicine inheritance assistance system, the software integration of mutual information improvement method, complex system entropy clustering and unsupervised entropy-level clustering data mining methods was adopted to analyze the rules of traditional Chinese medicine prescriptions for cancer. Totally 114 prescriptions were selected, the frequency of herbs in prescription was determined, and 85 core combinations and 13 new prescriptions were indentified. The traditional Chinese medicine inheritance assistance system, as a valuable traditional Chinese medicine research-supporting tool, can be used to record, manage, inquire and analyze prescription data.

Radiopharmaceutical prescription in nuclear medicine departments; La prescription medicale des radiopharmaceutiques au sein d'un service de medecine nucleaire

Energy Technology Data Exchange (ETDEWEB)

Biechlin-Chassel, M.L. [Radiopharmacie, service de pharmacie, Centre hospitalier de Chambery, 73 - Chambery (France); Lao, S. [Service de medecine nucleaire, CHU-Hopital de l' Archet, 06 - Nice (France); Bolot, C. [Service de pharmacie, hospices civiles de Lyon, groupement hospitalier Est, 69 - Bron (France); Francois-Joubert, A. [Service de medecine nucleaire, centre hospitalier de Chambery, 73 - Chambery (France)

2010-11-15

In France, radiopharmaceutical prescription is often discussed depending to which juridical structure the nuclear medicine department is belonging. According to current regulation, this prescription is an obligation in a department linked to hospital with a pharmacy department inside. But situation remains unclear for independent nuclear medicine departments where physicians are not constrained to prescribe radiopharmaceuticals. However, as radiographers and nurses are only authorized to realize theirs acts in front of a medical prescription, one prescription must be realized. Nowadays, computerized prescription tools have been developed but only for radiopharmaceutical drugs and not for medical acts. In the aim to achieve a safer patient care, the prescription regulation may be applied whatever differences between nuclear medicines departments. (authors)

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

Science.gov (United States)

Copeland, C

1999-04-01

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

75 FR 16235 - Electronic Prescriptions for Controlled Substances

Science.gov (United States)

2010-03-31

... mature standard for the formatting of prescription data, most electronic prescriptions are routed from... prescriptions prior to granting access to sign such prescriptions, two-factor authentication including a hard... practitioner can retain control of a biometric or hard token. Authentication based only on knowledge factors is...

Evolution of the earliest mantle caused by the magmatism-mantle upwelling feedback: Implications for the Moon and the Earth

Science.gov (United States)

Ogawa, M.

2017-12-01

The two most important agents that cause mantle evolution are magmatism and mantle convection. My earlier 2D numerical models of a coupled magmatism-mantle convection system show that these two agents strongly couple each other, when the Rayleigh number Ra is sufficiently high: magmatism induced by a mantle upwelling flow boosts the upwelling flow itself. The mantle convection enhanced by this positive feedback (the magmatism-mantle upwelling, or MMU, feedback) causes vigorous magmatism and, at the same time, strongly stirs the mantle. I explored how the MMU feedback influences the evolution of the earliest mantle that contains the magma ocean, based on a numerical model where the mantle is hot and its topmost 1/3 is partially molten at the beginning of the calculation: The evolution drastically changes its style, as Ra exceeds the threshold for onset of the MMU feedback, around 107. At Ra 107, however, the mantle remains compositionally more homogeneous in spite of the widespread magmatism, and the deep mantle remains hotter than the shallow mantle, because of the strong convective stirring caused by the feedback. The threshold value suggests that the mantle of a planet larger than Mars evolves in a way substantially different from that in the Moon does. Indeed, in my earlier models, magmatism makes the early mantle compositionally stratified in the Moon, but the effects of strong convective stirring overwhelms that of magmatism to keep the mantle compositionally rather homogeneous in Venus and the Earth. The MMU feedback is likely to be a key to understanding why vestiges of the magma ocean are so scarce in the Earth.

[Standardization of names in prescriptions of traditional Chinese medicines].

Science.gov (United States)

Li, Chao-Feng; Zhang, Yu-Jun; Fan, Dong-He; Zhang, Meng-Jie; Bai, Xue; Yang, Wen-Hua; Qi, Shu-Ya; Zhang, Zhi-Jie; Xue, Chun-Miao; Mao, Liu-Ying; Cao, Jun-Ling

2017-01-01

Chinese medicine prescriptions are a type of medical documents written by doctors after they understand the patients' conditions for syndrome differentiation. Chinese medicine prescriptions are also the basis for pharmacy personnel to dispense medicines and guide patients to use drugs. It has the legal, technical and economic significances. Chinese medicine prescriptions contain such information of names, quantity and usage. Whether the names of drugs in Chinese medicine prescriptions are standardized or not is directly related to the safety and efficacy of the drugs. At present, nonstandard clinical prescriptions are frequently seen. With "Chinese medicine prescription", "names of drug in Chinese medicine prescription" and "standards of Chinese medicine prescription" as key words, the author searched CNKI, Wanfang and other databases, and consulted nearly 100 literatures, so as to summarize current names of drugs in traditional Chinese medicine prescription, analyze the reasons, and give suggestions, in the expectation of standardizing the names of drugs used in traditional Chinese medicine prescriptions. Copyright© by the Chinese Pharmaceutical Association.

The computational challenges of Earth-system science.

Science.gov (United States)

O'Neill, Alan; Steenman-Clark, Lois

2002-06-15

The Earth system--comprising atmosphere, ocean, land, cryosphere and biosphere--is an immensely complex system, involving processes and interactions on a wide range of space- and time-scales. To understand and predict the evolution of the Earth system is one of the greatest challenges of modern science, with success likely to bring enormous societal benefits. High-performance computing, along with the wealth of new observational data, is revolutionizing our ability to simulate the Earth system with computer models that link the different components of the system together. There are, however, considerable scientific and technical challenges to be overcome. This paper will consider four of them: complexity, spatial resolution, inherent uncertainty and time-scales. Meeting these challenges requires a significant increase in the power of high-performance computers. The benefits of being able to make reliable predictions about the evolution of the Earth system should, on their own, amply repay this investment.

Abuse of prescription medicines in southwestern France.

Science.gov (United States)

Baumevieille, M; Haramburu, F; Bégaud, B

1997-01-01

Few quantitative data are available concerning abuse of medicine in the general population, although dependence on prescription medicines involves a significant proportion of the population. Falsified prescription forms can be used as an indicator of abuse. Community pharmacists in a representative network were asked to report any falsified prescription form presented over a 1-year period. Sales data were used to express results as abuse rate and abuse rate ratio. Two-thirds of the 130 pharmacies in the network reported at least 1 falsified prescription. The reported incidence of falsified prescriptions was 2.3 per 10 000 inhabitants. A total of 392 falsified prescription forms was collected. The abuse rate ratios were 171 (95% CI 140 to 210) for dextroamphetamine-phenobarbital in combination, 168 (95% CI 131 to 216) for fenozolone, 67 (95% CI 53 to 84) for buprenorphine, and 40.5 (95% CI 33 to 50) for clobenzorex. These results show the efficiency of a method for detecting falsified prescriptions forms using community pharmacists. The abuse of medicines already known for their addictive potential can be estimated and alerts can also be detected.

Is lithostatic loading important for the slip behavior and evolution of normal faults in the Earth's crust?

International Nuclear Information System (INIS)

Kattenhorn, Simon A.; Pollard, David D.

1999-01-01

Normal faults growing in the Earth's crust are subject to the effects of an increasing frictional resistance to slip caused by the increasing lithostatic load with depth. We use three-dimensional (3-D) boundary element method numerical models to evaluate these effects on planar normal faults with variable elliptical tip line shapes in an elastic solid. As a result of increasing friction with depth, normal fault slip maxima for a single slip event are skewed away from the fault center toward the upper fault tip. There is a correspondingly greater propagation tendency at the upper tip. However, the tall faults that would result from such a propagation tendency are generally not observed in nature. We show how mechanical interaction between laterally stepping fault segments significantly competes with the lithostatic loading effect in the evolution of a normal fault system, promoting lateral propagation and possibly segment linkage. Resultant composite faults are wider than they are tall, resembling both 3-D seismic data interpretations and previously documented characteristics of normal fault systems. However, this effect may be greatly complemented by the influence of a heterogeneous stratigraphy, which can control fault nucleation depth and inhibit fault propagation across the mechanical layering. Our models demonstrate that although lithostatic loading may be an important control on fault evolution in relatively homogeneous rocks, the contribution of lithologic influences and mechanical interaction between closely spaced, laterally stepping faults may predominate in determining the slip behavior and propagation tendency of normal faults in the Earth's crust. (c) 1999 American Geophysical Union

Prescription History of Emergency Department Patients Prescribed Opioids

Directory of Open Access Journals (Sweden)

Jason A Hoppe

2013-05-01

Full Text Available Introduction: To use Colorado’s prescription drug monitoring program (PDMP to describe the recent opioid prescription history of patients discharged from our emergency department (ED with a prescription for opioid pain medications.Methods: Retrospective cohort study of 300 adult ED patients who received an opioid prescription. We abstracted prescription histories for the six months prior to the ED visit from the PDMP, and abstracted clinical and demographic variables from the chart.Results: There were 5,379 ED visits during the study month, 3,732 of which were discharged. Providers wrote 1,165 prescriptions for opioid analgesics to 1,124/3,732 (30% of the patients. Median age was 36 years. Thirty-nine percent were male. Patients were 46% Caucasian, 26% African American, 22% Hispanic, 2% Asian and 4% other. These were similar to our overall ED population. There was substantial variability in the number of prescriptions, prescribers and total number of pills. A majority (205/296 of patients had zero or one prescription. The 90th percentile for number of prescriptions was seven, while the 10th percentile was zero. Patients in the highest decile tended to be older, with a higher proportion of Caucasians and females. Patients in the lowest decile resembled the general ED population. The most common diagnoses associated with opioid prescriptions were abdominal pain (11.5%, cold/flu symptoms (9.5%, back pain (5.4%, flank pain (5.0% and motor vehicle crash (4.7%.Conclusion: Substantial variability exists in the opioid prescription histories of ED patients, but a majority received zero or one prescription in the preceding six months. The top decile of patients averaged more than two prescriptions per month over the six months prior to ED visit, written by more than 6 different prescribers. There was a trend toward these patients being older, Caucasian and female. [West J Emerg Med. 2013;14(3:247–252.

Evolution: from cosmogenesis to biogenesis

International Nuclear Information System (INIS)

Lukacs, B.; Berczi, Sz.; Molnar, I.; Paal, G.

1990-11-01

The volume contains the material of an interdisciplinary evolution symposium. The purpose was to shed some light on possible connections between steps of evolution of matter on different levels of organisation. The topics involved are as follow: cosmogenesis; galactic and stellar evolution; formation and evolution of the solar system; global atmospheric and tectonic changes of Earth; viral evolution; phylogeny and evolution of terrestrial life; evolution of neural system; hominization. The material also includes some discussions of the underlying phenomena and laws of nature. (author)

Prescription Drug Abuse and Youth. Information Brief.

Science.gov (United States)

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

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

Assessment of legibility and completeness of handwritten and electronic prescriptions.

Science.gov (United States)

Albarrak, Ahmed I; Al Rashidi, Eman Abdulrahman; Fatani, Rwaa Kamil; Al Ageel, Shoog Ibrahim; Mohammed, Rafiuddin

2014-12-01

To assess the legibility and completeness of handwritten prescriptions and compare with electronic prescription system for medication errors. Prospective study. King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia. Handwritten prescriptions were received from clinical units of Medicine Outpatient Department (MOPD), Primary Care Clinic (PCC) and Surgery Outpatient Department (SOPD) whereas electronic prescriptions were collected from the pediatric ward. The handwritten prescription was assessed for completeness by the checklist designed according to the hospital prescription and evaluated for legibility by two pharmacists. The comparison between handwritten and electronic prescription errors was evaluated based on the validated checklist adopted from previous studies. Legibility and completeness of prescriptions. 398 prescriptions (199 handwritten and 199 e-prescriptions) were assessed. About 71 (35.7%) of handwritten and 5 (2.5%) of electronic prescription errors were identified. A significant statistical difference (P prescriptions in omitted dose and omitted route of administration category of error distribution. The rate of completeness in patient identification in handwritten prescriptions was 80.97% in MOPD, 76.36% in PCC and 85.93% in SOPD clinic units. Assessment of medication prescription completeness was 91.48% in MOPD, 88.48% in PCC, and 89.28% in SOPD. This study revealed a high incidence of prescribing errors in handwritten prescriptions. The use of e-prescription system showed a significant decline in the incidence of errors. The legibility of handwritten prescriptions was relatively good whereas the level of completeness was very low.

Astrophysics and Weak Form of Panspermia Hypothesis and Exogenous Factors in the Evolution of the Earth

Science.gov (United States)

Adushkin, V. V.; Vityazev, A. V.; Glazachev, D. O.; Pechernikova, G. V.

2014-10-01

The problems of the origin of Earth and life are fundamental in the modern science. We, relying on the data of resent years, contemplate a new course of research in this old problem. On the base of astrophysical data, obtained during the last 30-50 years, and the resent results of the study of small bodies in the Solar System (comets in particular) it is possible to combine the old idea about panspermia in a comprehensive sense and the search of the basis of life on the early Earth grounded on theoretical and laboratory data on the Earth evolution. Most likely, the Sun and a gas-and-dust disk surrounding it were created in a Giant molecular cloud near young giants - blue O-B-stars which ultraviolet radiation provided a weak chirality (to 15% of EEs) in organics of interstellar dust. Further a part of interstellar dust beyond orbits larger than 3-4 a.u. remained cold and then entered into the first planetesimals. The organics, after melting of interiors of the first planetesimals due to the heating by shortliving 26Al and 60Fe, sank, in the form of kerogens, into the core where formation of the first complex organic compounds began. This occurred in the first 3-4 Myr after the CAI. Apparently, it is necessary to look for anaerobic life in comets. In geosciences obtained various data banks, such as data on the endogenous activity of the Earth, mass extinctions of life and changes in biodiversity, impacts of cosmic bodies, inversions of the magnetic field, climate change, etc. The problem of cyclicity and correlation of all these processes is studied for 50 years. Results of spectral, wavelet and correlation analysis of the data series, representing some of these processes are given. We conclude, that most of them are cyclic, some of the periods are present in all the processes. The mechanisms of the influence of the galaxy on the processes occurring on the Earth are discussed.

The Evolution of the Earth's Magnetic Field.

Science.gov (United States)

Bloxham, Jeremy; Gubbins, David

1989-01-01

Describes the change of earth's magnetic field at the boundary between the outer core and the mantle. Measurement techniques used during the last 300 years are considered. Discusses the theories and research for explaining the field change. (YP)

Using prescription registries to define continuous drug use: how to fill gaps between prescriptions

DEFF Research Database (Denmark)

Nielsen, Lars Hougaard; Løkkegaard, Ellen; Andreasen, Anne Helms

2008-01-01

Pharmacoepidemiological studies often use prescription registries to assess patients' drug episodes. The databases usually provide information on the date of the redemption of the prescription as well as on the dispensed amount, and this allows us to define episodes of drug use. However, when...... that the retrospective exposure definition introduces an artificially protective effect of HT....

Opioid Prescriptions by Specialty in Ohio, 2010-2014.

Science.gov (United States)

Weiner, Scott G; Baker, Olesya; Rodgers, Ann F; Garner, Chad; Nelson, Lewis S; Kreiner, Peter W; Schuur, Jeremiah D

2018-05-01

The current US opioid epidemic is attributed to the large volume of prescribed opioids. This study analyzed the contribution of different medical specialties to overall opioids by evaluating the pill counts and morphine milligram equivalents (MMEs) of opioid prescriptions, stratified by provider specialty, and determined temporal trends. This was an analysis of the Ohio prescription drug monitoring program database, which captures scheduled medication prescriptions filled in the state as well as prescriber specialty. We extracted prescriptions for pill versions of opioids written in the calendar years 2010 to 2014. The main outcomes were the number of filled prescriptions, pill counts, MMEs, and extended-released opioids written by physicians in each specialty, and annual prescribing trends. There were 56,873,719 prescriptions for the studied opioids dispensed, for which 41,959,581 (73.8%) had prescriber specialty type available. Mean number of pills per prescription and MMEs were highest for physical medicine/rehabilitation (PM&R; 91.2 pills, 1,532 mg, N = 1,680,579), anesthesiology/pain (89.3 pills, 1,484 mg, N = 3,261,449), hematology/oncology (88.2 pills, 1,534 mg, N = 516,596), and neurology (84.4 pills, 1,230 mg, N = 573,389). Family medicine (21.8%) and internal medicine (17.6%) wrote the most opioid prescriptions overall. Time trends in the average number of pills and MMEs per prescription also varied depending on specialty. The numbers of pills and MMEs per opioid prescription vary markedly by prescriber specialty, as do trends in prescribing characteristics. Pill count and MME values define each specialty's contribution to overall opioid prescribing more accurately than the number of prescriptions alone.

Abuse of prescription drugs.

Science.gov (United States)

Wilford, B B

1990-01-01

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

21 CFR 886.5844 - Prescription spectacle lens.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Prescription spectacle lens. 886.5844 Section 886...) MEDICAL DEVICES OPHTHALMIC DEVICES Therapeutic Devices § 886.5844 Prescription spectacle lens. (a) Identification. A prescription spectacle lens is a glass or plastic device that is a lens intended to be worn by...

21 CFR 202.1 - Prescription-drug advertisements.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Prescription-drug advertisements. 202.1 Section 202.1 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG ADVERTISING § 202.1 Prescription-drug advertisements. (e) * * * (6) * * * (ii) Represents or suggests that a...

Assessment of prescription sales in Ukraine

Directory of Open Access Journals (Sweden)

N. V. Teterich

2013-10-01

Full Text Available Currently, the state of the national health system (health is characterized by a low level of funding for medical and pharmaceutical care and the lack of effective methods of free and preferential dispensing of medicines (drugs and compensation of their value. Thus the most urgent problem arises is unregulated drugs prescription, which is one of the main negative factors behind the rapid spread of self-medication and polypragmasy. Thus, improving drugs prescription dispensing is one of the current challenges of medicine and pharmacy management which should be solved to provide a safe, rational and effective drug therapy. The results of the questionnaire survey of doctors and pharmaceutical workers identified and explored key factors that contribute to a violation of drugs prescription. The authors analyzed the literature on the current state of drugs prescription in Ukraine, which resulted in selected priority issues that need resolution as soon as possible. Established that the main disadvantages of the national health care system is unreasonable approach to state regulation of the relevant system and the low level of funding. This situation prevents rational regulation of free and preferential delivery of drugs, the introduction of obligatory medical insurance and the reimbursement cost of drugs and other modern approaches that are effective in developed countries. Тhe main motive of view of legislative acts to implement strict drugs prescription in Ukraine is a link to international experience, guided by the standards of European and international practices that do not comply with the Law of Ukraine issued on 18.03.2004 № 1629-IV «On the National Program for Adaptation of Ukraine to the European Union, "and points to the disparity modern domestic rule-making European practice. The fundamental problem here is the comparison of the legal, social, financial and economic status of the counter in Ukraine with the countries in which the system

Global gravity and the geodynamic model of the Earth

International Nuclear Information System (INIS)

Nedoma, J.

1988-01-01

Plate tectonic hypotheses require the formation of a new oceanic lithosphere at mid-oceanic ridges and imply the further modification and continued evolution towards the continental type of lithosphere in the regions of island arcs and orogenic belts. All these phenomena observed on the Earths's surface are results of all geodynamic processes passing through the Earth's interior. Since geodynamic processes change through the geological epochs, the gravity field also changes during the same geological periods. Thus, the paper is concerned with physical relationships between the global gravity field and the geodynamic processes as well as all geophysical fields affected by the geodynamic processes inside the Earth. The aim of this paper is to analyse the inner and outer gravity field of the Earth during the evolution of the Earth in the course of the geological epochs, and to build the generalized theory of the global gravity field of the Earth from the point of view of the global and local geodynamic processes taking place within the Earth's interior. (author)

Drug prescriptions in Danish out-of-hours primary care

DEFF Research Database (Denmark)

Christensen, Morten Bondo; Nørøxe, Karen Busk; Moth, Grete

2016-01-01

of prescriptions per 100 contacts. RESULTS: Of 644,777 contacts, 154,668 (24.0%) involved medication prescriptions; 21.9% of telephone consultations, 32.9% of clinic consultations and 14.3% of home visits. Around 53% of all drug prescriptions were made in telephone consultations. Anti-infective medications...... for systemic use accounted for 45.5% of all prescriptions and were the most frequently prescribed drug group for all contact types, although accounting for less than 1/3 of telephone prescriptions. Other frequently prescribed drugs were ophthalmological anti-infectives (10.5%), NSAIDs (6.4%), opioids (3......) primary care services cover more than 75% of all hours during a normal week, insight into the extent and type of OOH drug prescription is important. General practitioners (GPs) are responsible for more than 80% of all drug prescriptions in Denmark. Of all contacts 24.0% involved medication prescriptions...

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

Science.gov (United States)

Cutler, Kristin A.

2014-01-01

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

Energy resources for mankind considered from the earth evolution

International Nuclear Information System (INIS)

Ohno, Shin-ich; Shimizu, Saburo

2005-01-01

The amount of energy resources contained in Earth and that we mankind can use in future can be estimated on the basis of the information given by astrophysical and geochemical considerations. The kind of resources includes geothermal, nuclear, solar, and fossil energy. We believe that the results of these considerations, especially the method of thinking, may be taken into curriculum in high schools or introductory courses of university education. In school education relating to energy and environmental problems we think that it is more important for the students to learn how to think or estimate and how to solve the problems than to be given any established knowledge itself from the teachers and reference books or journals. Students are easily discouraged by teachers who are talking that petroleum will be exhausted in 40 years or that uranium-235 will be also exhausted unless we develop the nuclear fuel system utilizing uranium-238 breading. They seem afraid of insufficient left when they grow old. In this report we call the readers attention that the amount of energy resources contained in Earth is such that the mankind can never exhaust them and that they are waiting to be exploited or for the time to come when the technology for their utilization is developed. We also pay attention that too much consumption of energy surely affect the earth environment (heat pollution) - the limit will be the consumption rate of about 0.1 W/m 2 of the earth surface which equals to the heat emission rate from the earth surface toward the space. (author)

A Prescription Survey from Sri Lanka

African Journals Online (AJOL)

adherence to standard guidelines on the layout and content of prescriptions. Method: A ... Conclusion: Prescription errors are common in outpatient settings of Aluthgama and Kandy areas in .... qualification of the prescriber was present, it was.

Increasing access to emergency contraception through online prescription requests.

Science.gov (United States)

Averbach, Sarah; Wendt, Jacqueline Moro; Levine, Deborah K; Philip, Susan S; Klausner, Jeffrey D

2010-01-01

To describe a pilot program, Plan B Online Prescription Access, to provide easy access to prescriptions for emergency contraception via the Internet. We measured electronic prescriptions for Plan B (Duramed Pharmaceuticals, Cincinnati, Ohio) by month over time. Pharmacists faxed patient-generated prescriptions back to the Department of Public Health for confirmation. Despite no marketing, within the first 18 months of the program, 152 electronic prescriptions for Plan B were requested by 128 female San Francisco residents. Seventy-eight prescriptions were filled (51%) by pharmacists. If correctly marketed, online prescriptions for Plan B have the potential to be an effective means of increasing emergency contraception access in both urban and rural settings across the United States. Further user-acceptability studies are warranted.

Radiation chemistry and origins of life on earth

International Nuclear Information System (INIS)

Zagorski, Z. P.

2001-01-01

The role of radiation chemical processes in prebiotic time of earth history and their influence on arise of organic life on Earth has been discussed. The formation of chiral compounds in prebiotic s oup' and its further evolution for creation of bioorganic molecules was also presented and discussed as an alternative of existing hypothesis of cosmic origin of biologic life in the Earth

NASA's Earth Science Data Systems

Science.gov (United States)

Ramapriyan, H. K.

2015-01-01

NASA's Earth Science Data Systems (ESDS) Program has evolved over the last two decades, and currently has several core and community components. Core components provide the basic operational capabilities to process, archive, manage and distribute data from NASA missions. Community components provide a path for peer-reviewed research in Earth Science Informatics to feed into the evolution of the core components. The Earth Observing System Data and Information System (EOSDIS) is a core component consisting of twelve Distributed Active Archive Centers (DAACs) and eight Science Investigator-led Processing Systems spread across the U.S. The presentation covers how the ESDS Program continues to evolve and benefits from as well as contributes to advances in Earth Science Informatics.

A smart-card-enabled privacy preserving E-prescription system.

Science.gov (United States)

Yang, Yanjiang; Han, Xiaoxi; Bao, Feng; Deng, Robert H

2004-03-01

Within the overall context of protection of health care information, privacy of prescription data needs special treatment. First, the involvement of diverse parties, especially nonmedical parties in the process of drug prescription complicates the protection of prescription data. Second, both patients and doctors have privacy stakes in prescription, and their privacy should be equally protected. Third, the following facts determine that prescription should not be processed in a truly anonymous manner: certain involved parties conduct useful research on the basis of aggregation of prescription data that are linkable with respect to either the patients or the doctors; prescription data has to be identifiable in some extreme circumstances, e.g., under the court order for inspection and assign liability. In this paper, we propose an e-prescription system to address issues pertaining to the privacy protection in the process of drug prescription. In our system, patients' smart cards play an important role. For one thing, the smart cards are implemented to be portable repositories carrying up-to-date personal medical records and insurance information, providing doctors instant data access crucial to the process of diagnosis and prescription. For the other, with the secret signing key being stored inside, the smart card enables the patient to sign electronically the prescription pad, declaring his acceptance of the prescription. To make the system more realistic, we identify the needs for a patient to delegate his signing capability to other people so as to protect the privacy of information housed on his card. A strong proxy signature scheme achieving technologically mutual agreements on the delegation is proposed to implement the delegation functionality.

Prosthesis Prescription Protocol of the Arm (PPP-Arm) : The implementation of a national prosthesis prescription protocol

NARCIS (Netherlands)

Wijdenes, Paula; Brouwers, Michael; van der Sluis, Corry K

BACKGROUND AND AIM: In order to create more uniformity in the prescription of upper limb prostheses by Dutch rehabilitation teams, the development and implementation of a Prosthesis Prescription Protocol of the upper limb (PPP-Arm) was initiated. The aim was to create a national digital protocol to

An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions

OpenAIRE

Islam, M Mofizul; McRae, Ian S

2014-01-01

Background In an effort to control non-medical use and/or medical abuse of prescription drugs, particularly prescription opioids, electronic prescription drug monitoring programs (PDMP) have been introduced in North-American countries, Australia and some parts of Europe. Paradoxically, there are simultaneous pressures to increase opioid prescribing for the benefit of individual patients and to reduce it for the sake of public health, and this pressure warrants a delicate balance of appropriat...

Age of the earth and solar system

International Nuclear Information System (INIS)

Manhes, G.

1977-01-01

The history of chemical element formation and radiochronology is given. The study of Pb isotope composition evolution enables to estimate the age of the earth. A series of galena of known ages was measured. By means of a model, it is possible to determine the initial isotope composition of Pb on the earth and the age of the earth. On the other hand, the analysis of stony meteorites provides a Pb isotope composition higher than the earth value. A comparison of the data shows a fundamental transition at 4.55 10 9 years [fr

Neon and xenon isotopes in MORB: Implications for the earth-atmosphere evolution

International Nuclear Information System (INIS)

Marty, B.

1989-01-01

The isotopic composition of neon and xenon measured in MORB glasses confirm significant deviations from atmospheric values. There are 1. 21 Ne excesses with are attributed to nucleogenic reactions in the mantle; 2. 20 Ne/ 22 Ne ratios higher than the air ratio interpreted as an evidence for the occurrence of solar-type Ne at depth; 3. 129 Xe and 131-136 Xe excesses, attributed to both extinct ( 129 I and 244 Pu) and present ( 238 U) radioactivities. Ne and Xe isotopic signatures in the mantle can hardly be explained in the framework of classical models for the atmospheric evolution (which postulate a mantle origin for atmospheric gases) and appeal for at least two sources of gases. Ne isotopic differences between air and MORB appear too large to be accounted for by any reasonable fractionation process in the mantle. They imply either fractionation of neon during hydrodynamic escape of a primary atmosphere or different degrees of mixing between primordial Ne components, which, in turn imply isolation of the surface reservoir (air) and deep reservoir (mantle) from the accretional period (except for mantle outgassing through volcanism, the contribution of which is 41% at best for 20 Ne). 129 I- 129 Xe, 244 Pu- 238 U- 136 Xe systematics for atmospheric and MORB-type xenon suggest that either atmospheric gases derived from a source whose formation was delayed (≥ 17 Ma) with respect to the mean accretion time of the mantle source and/or atmospheric gases and MORB-type gases derived from chemically distinct sources. These features are consistent with heterogeneous accretion models for the Earth. Volatile degassing was probably contemporaneous to accretional events, following impact degassing, and might have been most efficient during the late stages of Earth formation. (orig.)

The use of psychoactive prescription drugs among DUI suspects.

Science.gov (United States)

Karjalainen, Karoliina; Haukka, Jari; Lintonen, Tomi; Joukamaa, Matti; Lillsunde, Pirjo

2015-10-01

The study seeks to increase understanding of the use of psychoactive prescription drugs among persons suspected of driving under the influence (DUI). We studied whether the use of prescribed psychoactive medication was associated with DUI, and examined the difference in the use of prescription drugs between DUI recidivists and those arrested only once. In this register-based study, persons suspected of DUI (n=29470) were drawn from the Register of DUI suspects, and an age- and gender-matched reference population (n=30043) was drawn from the Finnish general population. Data on prescription drug use was obtained by linkage to the National Prescription Register. The associations of DUI arrest and use of psychoactive prescription drugs in different DUI groups (findings for alcohol only, prescription drugs, prescription drugs and alcohol, illicit drugs) were estimated by using mixed-effect logistic regression. The use of psychoactive prescription drugs and DUI appeared to be strongly associated, with DUI suspects significantly more likely to use psychoactive prescription drugs compared to the reference population. Gender differences existed, with the use of benzodiazepines being more common among female DUI suspects. Moreover, DUI recidivists were more likely to use psychoactive prescription drugs compared to those arrested only once. In addition to alcohol and/or illicit drug use, a significant proportion of DUI suspects were using psychoactive prescription drugs. When prescribing psychoactive medication, especially benzodiazepines, physicians are challenged to screen for possible substance use problems and also to monitor for patients' alcohol or illicit drug use while being medicated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Long time-scale fluctuations in the evolution of the Earth

International Nuclear Information System (INIS)

McCrea, W.H.

1981-01-01

Current knowledge about certain terrestrial phenomena is reviewed: (a) to discover the extent to which the behaviour of the Earth may be influenced by fluctuations in its astronomical environment and (b) to see if new knowledge of that environment may be gained from its influence on the Earth. Fluctuations in geomagnetism, climate, glaciation, biological extinctions etc. are surveyed with special regard to datings and characteristic time-intervals; correlations between such fluctuations are discussed. Astronomical phenomena, within the Solar System and elsewhere in the Galaxy, that might cause terrestrial effects are reviewed. Fluctuations of glaciation within an ice-epoch may result from changes of insolation accompanying fluctuations of the Earth's motion relative to the Sun. Some evidence suggests that an ice-epoch may be triggered by variations of the astronomical environment encountered in the Sun's motion relative to the Galaxy; but tectonic changes on Earth may be the main trigger. Impacts of planetesimals may be more important than hitherto recognized. Although the intensity of solar 'activity' is variable, terrestrial effects provide no confirmation that the Sun is a 'variable star'. As for the Galaxy, impacting planetesimals may originate in interstellar clouds, and so provide on Earth samples of interstellar matter. Some unsolved problems emphasized by the review are listed. (U.K.)

Long time-scale fluctuations in the evolution of the Earth

Energy Technology Data Exchange (ETDEWEB)

McCrea, W H [Sussex Univ., Brighton (UK). Astronomy Centre

1981-02-18

Current knowledge about certain terrestrial phenomena is reviewed: (a) to discover the extent to which the behaviour of the Earth may be influenced by fluctuations in its astronomical environment and (b) to see if new knowledge of that environment may be gained from its influence on the Earth. Fluctuations in geomagnetism, climate, glaciation, biological extinctions etc. are surveyed with special regard to datings and characteristic time-intervals; correlations between such fluctuations are discussed. Astronomical phenomena, within the Solar System and elsewhere in the Galaxy, that might cause terrestrial effects are reviewed. Fluctuations of glaciation within an ice-epoch may result from changes of insolation accompanying fluctuations of the Earth's motion relative to the Sun. Some evidence suggests that an ice-epoch may be triggered by variations of the astronomical environment encountered in the Sun's motion relative to the Galaxy; but tectonic changes on Earth may be the main trigger. Impacts of planetesimals may be more important than hitherto recognized. Although the intensity of solar 'activity' is variable, terrestrial effects provide no confirmation that the Sun is a 'variable star'. As for the Galaxy, impacting planetesimals may originate in interstellar clouds, and so provide on Earth samples of interstellar matter. Some unsolved problems emphasized by the review are listed.

Influence of pharmacists expertise on physicians prescription ...

African Journals Online (AJOL)

the prescribing behaviour of physicians. ... Keywords: Physician prescription behaviour, Pharmacist factor, Collaboration, Trustworthiness ... provide information relating to drug prescription, ... processing [22], which takes into consideration.

Past-year Prescription Drug Monitoring Program Opioid Prescriptions and Self-reported Opioid Use in an Emergency Department Population With Opioid Use Disorder.

Science.gov (United States)

Hawk, Kathryn; D'Onofrio, Gail; Fiellin, David A; Chawarski, Marek C; O'Connor, Patrick G; Owens, Patricia H; Pantalon, Michael V; Bernstein, Steven L

2017-11-22

Despite increasing reliance on prescription drug monitoring programs (PDMPs) as a response to the opioid epidemic, the relationship between aberrant drug-related behaviors captured by the PDMP and opioid use disorder is incompletely understood. How PDMP data should guide emergency department (ED) assessment has not been studied. The objective was to evaluate a relationship between PDMP opioid prescription records and self-reported nonmedical opioid use of prescription opioids in a cohort of opioid-dependent ED patients enrolled in a treatment trial. PDMP opioid prescription records during 1 year prior to study enrollment on 329 adults meeting Diagnostic and Statistical Manual IV criteria for opioid dependence entering a randomized clinical trial in a large, urban ED were cross-tabulated with data on 30-day nonmedical prescription opioid use self-report. The association among these two types of data was assessed by the Goodman and Kruskal's gamma; a logistic regression was used to explore characteristics of participants who had PDMP record of opioid prescriptions. During 1 year prior to study enrollment, 118 of 329 (36%) patients had at least one opioid prescription (range = 1-51) in our states' PDMP. Patients who reported ≥15 of 30 days of nonmedical prescription opioid use were more likely to have at least four PDMP opioid prescriptions (20/38; 53%) than patients reporting 1 to 14 days (14/38, 37%) or zero days of nonmedical prescription opioid use (4/38, 11%; p = 0.002). Female sex and having health insurance were significantly more represented in the PDMP (p Medicine.

Governmental oversight of prescribing medications: history of the US Food and Drug Administration and prescriptive authority.

Science.gov (United States)

Plank, Linda S

2011-01-01

The evolution of drug regulation and awarding of prescriptive authority is a complex and sometimes convoluted process that can be confusing for health care providers. A review of the history of how drugs have been manufactured and dispensed helps explain why this process has been so laborious and complicated. Because the federal and state governments have the responsibility for protecting the public, most regulations have been passed with the intentions of ensuring consumer safety. The current system of laws and regulations is the result of many years of using the legal system to correct drug marketing that had adverse health consequences. Government oversight will continue as prescribing medications transitions to an electronic form and as health care professionals in addition to physicians seek to gain prescriptive authority. © 2011 by the American College of Nurse-Midwives.

Evolution of the Oxidation State of the Earth's Mantle

Science.gov (United States)

Danielson, L. R.; Righter, K.; Keller, L.; Christoffersen, E.; Rahman, Z.

2015-01-01

The oxidation state of the Earth's mantle during formation remains an unresolved question, whether it was constant throughout planetary accretion, transitioned from reduced to oxidized, or from oxidized to reduced. We investigate the stability of Fe3(+) at depth, in order to constrain processes (water, late accretion, dissociation of FeO) which may reduce or oxidize the Earth's mantle. In our previous experiments on shergottite compositions, variable fO2, T, and P less than 4 GPa, Fe3(+)/sigma Fe decreased slightly with increasing P, similar to terrestrial basalt. For oxidizing experiments less than 7GPa, Fe3(+)/sigma Fe decreased as well, but it's unclear from previous modelling whether the deeper mantle could retain significant Fe3(+). Our current experiments expand our pressure range deeper into the Earth's mantle and focus on compositions and conditions relevant to the early Earth. Preliminary multi-anvil experiments with Knippa basalt as the starting composition were conducted at 5-7 GPa and 1800 C, using a molybdenum capsule to set the fO2 near IW, by buffering with Mo-MoO3. TEM and EELS analyses revealed the run products quenched to polycrystalline phases, with the major phase pyroxene containing approximately equal to Fe3(+)/2(+). Experiments are underway to produce glassy samples that can be measured by EELS and XANES, and are conducted at higher pressures.

How did Earth not End up like Venus?

Science.gov (United States)

Jellinek, M.; Lenardic, A.; Weller, M. B.

2017-12-01

Recent geodynamic calculations show that terrestrial planets forming with a chondritic initial bulk composition at order 1 AU can evolve to be either "Earth-like" or "Venus-like": Both mobile- and stagnant-lid tectonic regimes are permitted, neither solution is an explicitly stronger attractor and effects related to differences in Sun-Earth distance are irrelevant. What factors might then cause the thermal evolutionary paths of Earth and Venus to diverge dynamically at early times? At what point in Earth's evolution did plate tectonics emerge and when and how did this tectonic mode gain sufficient resilience to persist over much of Earth's evolution? What is the role of volatile cycling and climate: To what extent have the stable climate of Earth and the greenhouse runaway climate of Venus enforced their distinct tectonic regimes over time? In this talk I will explore some of the mechanisms potentially governing the evolutionary divergence of Earth and Venus. I will first review observational constraints that suggest that Earth's entry into the current stable plate tectonic mode was far from assured by 2 Ga. Next I will discuss how models have been used to build understanding of some key dynamical controls. In particular, the probability of "Earth-like" solutions is affected by: 1) small differences in the initial concentrations of heat producing elements (i.e., planetary initial conditions); 2) long-term climate change; and 3) the character of a planet's early evolutionary path (i.e., tectonic hysteresis).

Fluorine in the solar neighborhood: Chemical evolution models

Science.gov (United States)

Spitoni, E.; Matteucci, F.; Jönsson, H.; Ryde, N.; Romano, D.

2018-04-01

Context. In light of new observational data related to fluorine abundances in solar neighborhood stars, we present chemical evolution models testing various fluorine nucleosynthesis prescriptions with the aim to best fit those new data. Aim. We consider chemical evolution models in the solar neighborhood testing various nucleosynthesis prescriptions for fluorine production with the aim of reproducing the observed abundance ratios [F/O] versus [O/H] and [F/Fe] versus [Fe/H]. We study in detail the effects of various stellar yields on fluorine production. Methods: We adopted two chemical evolution models: the classical two-infall model, which follows the chemical evolution of halo-thick disk and thin disk phases; and the one-infall model, which is designed only for thin disk evolution. We tested the effects on the predicted fluorine abundance ratios of various nucleosynthesis yield sources, that is, asymptotic giant branch (AGB) stars, Wolf-Rayet (W-R) stars, Type II and Type Ia supernovae, and novae. Results: The fluorine production is dominated by AGB stars but the W-R stars are required to reproduce the trend of the observed data in the solar neighborhood with our chemical evolution models. In particular, the best model both for the two-infall and one-infall cases requires an increase by a factor of 2 of the W-R yields. We also show that the novae, even if their yields are still uncertain, could help to better reproduce the secondary behavior of F in the [F/O] versus [O/H] relation. Conclusions: The inclusion of the fluorine production by W-R stars seems to be essential to reproduce the new observed ratio [F/O] versus [O/H] in the solar neighborhood. Moreover, the inclusion of novae helps to reproduce the observed fluorine secondary behavior substantially.

The Effects of Bairesi Complex Prescription (a Uyghur Medicine Prescription and Its Five Crude Herbal Extracts on Melanogenesis in G-361 Cells

Directory of Open Access Journals (Sweden)

Xuedan Huang

2016-01-01

Full Text Available Vitiligo is considered a preimmune stage of a disease that is not well clarified. This condition is difficult to treat because there is no definite cure. Uyghur medicine is an important part of traditional Chinese medicine. There are many types of prescriptions that are used for the treatment of vitiligo. Bairesi complex prescription is one of the active prescriptions for vitiligo that is used in the clinic. However, the intensities of melanogenesis due to uses of Bairesi complex prescription and its five constituent crude herbs have not been reported yet. In the present study, we found that the hot water extracts of Bairesi complex prescription and the crude herbs were more effective in eliciting melanin production in G-361 cells than the EtOH extracts. Furthermore, the Bairesi complex prescription exhibited less cytotoxicity and was more effective in melanin formation than the five crude herbal extracts. In the present study, we also discuss the mechanisms of melanogenesis due to the use of the Bairesi complex prescription and its single crude herbal extracts.

Acceleration Processes in the Earth’s Magnetosphere.

Science.gov (United States)

1985-05-17

Hada, T. and T. Terasawa, Nonlinear evolution of low frequency waves in the foreshock region of earth’s bow shock, American Geophysical Union...low-frequency waves in the earth’s foreshock , American Geophysical Union, San Francisco, December 1984. 14) Ogino, T., R.J. Walker and M. Ashour

Thermochemical structure of the Earth's mantle and continental crust

DEFF Research Database (Denmark)

Guerri, Mattia

A detailed knowledge of the Earth's thermal structure and chemical composition is fundamental in order to understand the processes driving the planet ormation and evolution. The inaccessibility of most of the Earth's interior makes the determination of its thermo-chemical conditions a challenging...

Description, prescription and the choice of discount rates

International Nuclear Information System (INIS)

Baum, Seth D.

2009-01-01

The choice of discount rates is a key issue in the analysis of long-term societal issues, in particular environmental issues such as climate change. Approaches to choosing discount rates are generally placed into two categories: the descriptive approach and the prescriptive approach. The descriptive approach is often justified on grounds that it uses a description of how society discounts instead of having analysts impose their own discounting views on society. This paper analyzes the common forms of the descriptive and prescriptive approaches and finds that, in contrast with customary thinking, both forms are equally descriptive and prescriptive. The prescriptions concern who has standing (i.e. who is included) in society, how the views of these individuals are measured, and how the measurements are aggregated. Such prescriptions are necessary to choose from among the many possible descriptions of how society discounts. The descriptions are the measurements made given a choice of measurement technique. Thus, the labels 'descriptive approach' and 'prescriptive approach' are deeply misleading, as analysts cannot avoid imposing their own views on society. (author)

Effect of EHR user interface changes on internal prescription discrepancies.

Science.gov (United States)

Turchin, A; Sawarkar, A; Dementieva, Y A; Breydo, E; Ramelson, H

2014-01-01

To determine whether specific design interventions (changes in the user interface (UI)) of an electronic health record (EHR) medication module are associated with an increase or decrease in the incidence of contradictions between the structured and narrative components of electronic prescriptions (internal prescription discrepancies). We performed a retrospective analysis of 960,000 randomly selected electronic prescriptions generated in a single EHR between 01/2004 and 12/2011. Internal prescription discrepancies were identified using a validated natural language processing tool with recall of 76% and precision of 84%. A multivariable autoregressive integrated moving average (ARIMA) model was used to evaluate the effect of five UI changes in the EHR medication module on incidence of internal prescription discrepancies. Over the study period 175,725 (18.4%) prescriptions were found to have internal discrepancies. The highest rate of prescription discrepancies was observed in March 2006 (22.5%) and the lowest in March 2009 (15.0%). Addition of "as directed" option to the dropdown decreased prescription discrepancies by 195 / month (p = 0.0004). An non-interruptive alert that reminded providers to ensure that structured and narrative components did not contradict each other decreased prescription discrepancies by 145 / month (p = 0.03). Addition of a "Renew / Sign" button to the Medication module (a negative control) did not have an effect in prescription discrepancies. Several UI changes in the electronic medication module were effective in reducing the incidence of internal prescription discrepancies. Further research is needed to identify interventions that can completely eliminate this type of prescription error and their effects on patient outcomes.

Audit of carbapenem prescriptions comparing 2 assessment periods.

Science.gov (United States)

Lefébure, A; Papy, E; Rioux, C; Diamantis, S; Armand-Lefèvre, L; Longuet, P; Lescure, F X; Wolff, M; Arnaud, P; Lucet, J C

2015-07-01

The emergence of extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae has resulted in the increase of carbapenem prescriptions. The objective of our study was to determine the appropriateness of carbapenem prescriptions from initiation to reassessment of treatment, between 2009 and 2011. A questionnaire drafted by infectious diseases specialists (IDS) and microbiologists was used to collect clinical and microbiological data concerning carbapenem prescriptions in 2009 and 2011. An IDS then compared the results to assess carbapenem prescription compliance with our hospital's local recommendations. Seventy-one prescriptions were included in 2009 and 32 in 2011. The carbapenem treatment had been most frequently probabilistic to treat nosocomial infections. The microbiological data revealed that the number of multidrug-resistant (MDR) infections had increased between 2009 and 2011, especially infections involving ESBL-producing Enterobacteriaceae. At treatment reassessment, in 2009 and 2011, 15 (21%) and 12 (38%) carbapenem prescriptions were appropriate and continued. Overall, when comparing the 2 periods, prescriptions complied with local guidelines from initiation to reassessment of treatment without any statistically significant difference (68% in 2009 and 75% in 2011). Our study results showed that MDR infections had increased and especially infections due to ESBL-producing Enterobacteriaceae; this was consistent with epidemiological data. We also proved that most carbapenem prescriptions were compliant with recommendations. The increased mobile IDS interventions in medical and surgical departments helped reach this rate of compliance. Carbapenem stewardship may be promoted even in a difficult epidemiological context, especially with IDS interventions for the duration of treatment or at treatment reassessment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Subtypes of nonmedical prescription drug misuse

Science.gov (United States)

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

2010-01-01

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

NASA's Earth science flight program status

Science.gov (United States)

Neeck, Steven P.; Volz, Stephen M.

2010-10-01

NASA's strategic goal to "advance scientific understanding of the changing Earth system to meet societal needs" continues the agency's legacy of expanding human knowledge of the Earth through space activities, as mandated by the National Aeronautics and Space Act of 1958. Over the past 50 years, NASA has been the world leader in developing space-based Earth observing systems and capabilities that have fundamentally changed our view of our planet and have defined Earth system science. The U.S. National Research Council report "Earth Observations from Space: The First 50 Years of Scientific Achievements" published in 2008 by the National Academy of Sciences articulates those key achievements and the evolution of the space observing capabilities, looking forward to growing potential to address Earth science questions and enable an abundance of practical applications. NASA's Earth science program is an end-to-end one that encompasses the development of observational techniques and the instrument technology needed to implement them. This includes laboratory testing and demonstration from surface, airborne, or space-based platforms; research to increase basic process knowledge; incorporation of results into complex computational models to more fully characterize the present state and future evolution of the Earth system; and development of partnerships with national and international organizations that can use the generated information in environmental forecasting and in policy, business, and management decisions. Currently, NASA's Earth Science Division (ESD) has 14 operating Earth science space missions with 6 in development and 18 under study or in technology risk reduction. Two Tier 2 Decadal Survey climate-focused missions, Active Sensing of CO2 Emissions over Nights, Days and Seasons (ASCENDS) and Surface Water and Ocean Topography (SWOT), have been identified in conjunction with the U.S. Global Change Research Program and initiated for launch in the 2019

Overdosed prescription of paracetamol (acetaminophen) in a teaching hospital.

Science.gov (United States)

Charpiat, B; Henry, A; Leboucher, G; Tod, M; Allenet, B

2012-07-01

Paracetamol is the most commonly used analgesic and antipyretic. Reviews of hospital use of paracetamol are scarce. Little is known about the appropriateness of the dose of paracetamol prescribed for hospitalized adults. The aim of this study was to report on the nature and the frequency of the overdosed prescription of paracetamol observed in adult patients over a 4.5-year period in a teaching hospital. Prescription analysis by pharmacists was performed once a week in six medical and three surgical departments and daily in a post-emergency unit. In cases of prescription error, the pharmacist notified the physician through an electronic alert when a computerized prescription order entry system was available or otherwise by face-to-face discussion. For each drug-related problem detected, the pharmacists recorded relevant details in a database. From October 2006 to April 2011, 44,404 prescriptions were reviewed and 480 alerts related to the overdosed prescription of paracetamol were made (1% of analyzed prescriptions). The extent of errors of dosage was within the intervals [90-120 mg/kg/d] and greater than 120 mg/kg/d for 87 and 11 patients respectively, who were prescribed a single non-combination paracetamol containing product. Sixty alerts concerned co-prescription of at least two paracetamol containing products with similar frequency for computerized (1.4/1000) or handwritten (1.2/1000) prescriptions. Prescriptions of paracetamol for hospitalized adults frequently exceed the recommended dosage. These results highlight the need for increased awareness of unintentional paracetamol overdose and support the initiation of an educational program aimed at physicians and nurses. Copyright © 2012. Published by Elsevier Masson SAS.

Prescription analysis of pediatric outpatient practice in Nagpur city

Directory of Open Access Journals (Sweden)

Pandey Anuja

2010-01-01

Full Text Available Background: Medication errors are probably one of the most common types of medical errors, as medication is the most common health-care intervention. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. Objective: To study prescribing patterns and errors in pediatric OPD prescriptions presenting to four community pharmacies across Nagpur city and to compare the prescription error rates across prescriber profiles. Materials and Methods: The study sample included 1376 valid pediatric OPD prescriptions presenting to four randomly selected community pharmacies in Nagpur, collected over a period of 2 months. Confirmed errors in the prescriptions were reviewed and analyzed. The core indicators for drug utilization studies, mentioned by WHO, were used to define errors. Results: The 1376 prescriptions included in the study were for a total of 3435 drugs, prescribed by 41 doctors. Fixed dose formulations dominated the prescribing pattern, many of which were irrational. Prescribing by market name was almost universal and generic prescriptions were for merely 254 (7.4% drugs. The prescribing pattern also indicated polypharmacy with the average number of drugs per encounter of 2.5. Antibiotics were included in 1087 (79% prescriptions, while injectable drugs were prescribed in 22 (1.6% prescriptions. The prescription error score varied significantly across prescriber profiles. Conclusion: The findings of our study highlight the continuing crisis of the irrational drug prescribing in the country.

The feasibility of QR-code prescription in Taiwan.

Science.gov (United States)

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

2012-12-01

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

A BRIEF NOTE ON MINERAL EVOLUTION AND BIOCHEMISTRY

Directory of Open Access Journals (Sweden)

José María Amigó

2014-12-01

Full Text Available The natural inorganic materials (minerals and rocks exceed the limits of the Earth.Therefore, the geology, which is the study of the Earth, represents only a small part of thenatural inorganic world. Certain questions about the genesis of the universe are related tothe evolution of our solar system and the evolution of life on our planet. In this paper, recentcontributions from experimental physical natural-sciences to the formation of the universe(about 15 billion BP coupled with the occurrence of minerals (4 million years BP and thebiochemical appearance of life (not more than 3 million years on the Earth are discussed.When Earth was formed, none of the more than 4,400 minerals we know today were existed.Cosmologists estimate that nearly ten billion years after the Big Bang the first elementsproduced by the melting process. The geological history of mineral evolution on the Earthis an interesting tool to study terrestrial and/or extraterrestrial mineralogy in regard toastronomy, biology, chemistry and other experimental natural sciences

In search of future earths: assessing the possibility of finding Earth analogues in the later stages of their habitable lifetimes.

Science.gov (United States)

O'Malley-James, Jack T; Greaves, Jane S; Raven, John A; Cockell, Charles S

2015-05-01

Earth will become uninhabitable within 2-3 Gyr as a result of the increasing luminosity of the Sun changing the boundaries of the habitable zone (HZ). Predictions about the future of habitable conditions on Earth include declining species diversity and habitat extent, ocean loss, and changes to geochemical cycles. Testing these predictions is difficult, but the discovery of a planet that is an analogue to future Earth could provide the means to test them. This planet would need to have an Earth-like biosphere history and to be approaching the inner edge of the HZ at present. Here, we assess the possibility of finding such a planet and discuss the benefits of analyzing older Earths. Finding an old-Earth analogue in nearby star systems would be ideal, because this would allow for atmospheric characterization. Hence, as an illustrative example, G stars within 10 pc of the Sun are assessed as potential old-Earth-analog hosts. Six of these represent good potential hosts. For each system, a hypothetical Earth analogue is placed at locations within the continuously habitable zone (CHZ) that would allow enough time for Earth-like biosphere development. Surface temperature evolution over the host star's main sequence lifetime (assessed by using a simple climate model) is used to determine whether the planet would be in the right stage of its late-habitable lifetime to exhibit detectable biosignatures. The best candidate, in terms of the chances of planet formation in the CHZ and of biosignature detection, is 61 Virginis. However, planet formation studies suggest that only a small fraction (0.36%) of G stars in the solar neighborhood could host an old-Earth analogue. If the development of Earth-like biospheres is rare, requiring a sequence of low-probability events to occur, biosphere evolution models suggest they are rarer still, with only thousands being present in the Galaxy as a whole.

Effect of EHR User Interface Changes on Internal Prescription Discrepancies

Science.gov (United States)

Sawarkar, A.; Dementieva, Y.A.; Breydo, E.; Ramelson, H.

2014-01-01

Summary Objective To determine whether specific design interventions (changes in the user interface (UI)) of an electronic health record (EHR) medication module are associated with an increase or decrease in the incidence of contradictions between the structured and narrative components of electronic prescriptions (internal prescription discrepancies). Materials and Methods We performed a retrospective analysis of 960,000 randomly selected electronic prescriptions generated in a single EHR between 01/2004 and 12/2011. Internal prescription discrepancies were identified using a validated natural language processing tool with recall of 76% and precision of 84%. A multivariable autoregressive integrated moving average (ARIMA) model was used to evaluate the effect of five UI changes in the EHR medication module on incidence of internal prescription discrepancies. Results Over the study period 175,725 (18.4%) prescriptions were found to have internal discrepancies. The highest rate of prescription discrepancies was observed in March 2006 (22.5%) and the lowest in March 2009 (15.0%). Addition of „as directed“ option to the dropdown decreased prescription discrepancies by 195 / month (p = 0.0004). An non-interruptive alert that reminded providers to ensure that structured and narrative components did not contradict each other decreased prescription discrepancies by 145 / month (p = 0.03). Addition of a „Renew / Sign“ button to the Medication module (a negative control) did not have an effect in prescription discrepancies. Conclusions Several UI changes in the electronic medication module were effective in reducing the incidence of internal prescription discrepancies. Further research is needed to identify interventions that can completely eliminate this type of prescription error and their effects on patient outcomes. PMID:25298811

The Earth System Model

Science.gov (United States)

Schoeberl, Mark; Rood, Richard B.; Hildebrand, Peter; Raymond, Carol

2003-01-01

The Earth System Model is the natural evolution of current climate models and will be the ultimate embodiment of our geophysical understanding of the planet. These models are constructed from components - atmosphere, ocean, ice, land, chemistry, solid earth, etc. models and merged together through a coupling program which is responsible for the exchange of data from the components. Climate models and future earth system models will have standardized modules, and these standards are now being developed by the ESMF project funded by NASA. The Earth System Model will have a variety of uses beyond climate prediction. The model can be used to build climate data records making it the core of an assimilation system, and it can be used in OSSE experiments to evaluate. The computing and storage requirements for the ESM appear to be daunting. However, the Japanese ES theoretical computing capability is already within 20% of the minimum requirements needed for some 2010 climate model applications. Thus it seems very possible that a focused effort to build an Earth System Model will achieve succcss.

Rationality of Antimicrobial Prescriptions in Community Pharmacy Users.

Directory of Open Access Journals (Sweden)

Sara I V C Lima

Full Text Available Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs.A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug.Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.

Radiation and the evolution of life

International Nuclear Information System (INIS)

Gentner, N.E.; Myers, D.K.

1980-08-01

A general review is presented of the nature of various forms of radiation; radiant energy which reaches the earth from the sun; the role of this energy in prebiotic chemical evolution; current ideas on the origin of life; the dependence of living organisms upon radiant energy; the mechanisms responsible for the evolution of life, from the viewpoint of modern genetics and molecular biology; the biological consequences of alterations in the genetic material; and the role of ionizing radiation in production of genetic changes and in evolution. In the final analysis, the biosynthetic processes of life are driven by radiant energy from the sun. This overview is necessarily focussed on the infrared, visible and ultraviolet regions of the solar output spectrum since these particular radiations are responsible for most of the radiant energy that reaches the earth's surface. Ionizing radiation appears to have played at best a minor role in biological evolution. Small increments in the amounts of ionizing radiation are therefore unlikely to have a significant effect on life or its evolution. (auth)

The appropriateness of a proton pump inhibitor prescription.

LENUS (Irish Health Repository)

Moran, N

2014-11-01

Proton pump inhibitors (PPIs) are one of the most commonly prescribed groups of drug in Ireland, at great expense to the Irish healthcare executive. This study aims to evaluate the appropriateness of PPI prescriptions on admission and discharge in a tertiary referral hospital. All non-elective admissions in the Emergency Department in one week were included in the study. 102 patients in total were included, with 36 (35.4%) treated with a PPI on admission. Of these, only 3 (8.3%) had a clear indication noted as per current NICE guidelines. 18 new in-hospital PPI prescriptions were documented. 11 (61%) of which were present on discharge prescriptions. Continuing PPI prescription on discharge into the community may be inappropriate, costly and potentially harmful. Brief interventions aimed at reducing inappropriate PPI prescriptions have been shown to be effective at reducing the cost and potential harm of unnecessary treatment.

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

Science.gov (United States)

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

2015-01-01

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

Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants

Science.gov (United States)

Chen, Lian-Yu; Crum, Rosa M.; Strain, Eric C.; CalebAlexander, G.; Kaufmann, Christopher; Mojtabai, Ramin

2018-01-01

Objective Little is known regarding the temporal trends in prescription, nonmedical use and emergency department (ED) visits involving prescription stimulants in the United States. We aimed to examine the three national trends involving dextroamphetamine-amphetamin (Adderall) and methylphenidate in adults and adolescents. Method Three national surveys conducted between 2006-2011 were used: National Disease and Therapeutic Index (NDTI), a survey of office-based practices, National Survey on Drug Use and Health (NSDUH), a population survey of substance use, and Drug Abuse Warning Network (DAWN), a survey of ED visits. Ordinary least square regression was used to examine temporal changes over time and the associations between these three trends. Results In adolescents, treatment visits involving dextroamphetamine-amphetamine and methylphenidate decreased over time; nonmedical dextroamphetamine-amphetamine use remained stable while nonmedical methylphenidate use declined by 54.4% in 6 years. ED visits involving either medication remained stable. In adults, treatment visits involving dextroamphetamine-amphetamine remained unchanged while nonmedical use went up by 67% and ED visits went up by 156%. These three trends involving methylphenidate remained unchanged. The major source for both medications was a friend or relative across age groups; two-thirds of these friends/relatives had obtained the medication from a physician. Conclusions Trends of prescriptions for stimulants do not correspond to trends in reports of nonmedical use and ED visits. Increased nonmedical stimulant use may not be simply attributed to increased prescribing trends. Future studies should focus on deeper understanding of the proportion, risk factors and motivations for drug diversions. PMID:26890573

Identification and management of prescription drug abuse in pregnancy.

Science.gov (United States)

Worley, Julie

2014-01-01

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

Hybrid Differential Evolution Optimisation for Earth Observation Satellite Scheduling with Time-Dependent Earliness-Tardiness Penalties

Directory of Open Access Journals (Sweden)

Guoliang Li

2017-01-01

Full Text Available We study the order acceptance and scheduling (OAS problem with time-dependent earliness-tardiness penalties in a single agile earth observation satellite environment where orders are defined by their release dates, available processing time windows ranging from earliest start date to deadline, processing times, due dates, sequence-dependent setup times, and revenues. The objective is to maximise total revenue, where the revenue from an order is a piecewise linear function of its earliness and tardiness with reference to its due date. We formulate this problem as a mixed integer linear programming model and develop a novel hybrid differential evolution (DE algorithm under self-adaptation framework to solve this problem. Compared with classical DE, hybrid DE employs two mutation operations, scaling factor adaptation and crossover probability adaptation. Computational tests indicate that the proposed algorithm outperforms classical DE in addition to two other variants of DE.

Nature, frequency and determinants of prescription modifications in Dutch community pharmacies

Science.gov (United States)

Buurma, Henk; de Smet, Peter A G M; van den Hoff, Olga P; Egberts, Antoine C G

2001-01-01

Aims To examine the nature, frequency and determinants of prescription modifications in Dutch community pharmacies. Methods A prospective case-control study comparing modified prescriptions with nonmodified prescriptions was carried out in 141 Dutch community pharmacies. 2014 modified prescriptions (cases), collected in the selected pharmacies on a predetermined day in a specific period (25th February until 12th March 1999) and 2581 nonmodified prescriptions (controls) randomly selected on the same day were studied. The nature and frequency of prescription modifications and patient, drug and prescriber related determinants for a modified prescription were assessed. Results The overall incidence of prescription modifications was 4.3%, with a mean of 14.3 modifications per pharmacy per day. For prescription only medicines (POM) the incidence was 4.9%. The majority of POM modifications concerned a clarification (71.8%). In 22.2% a prescription could potentially have had clinical consequences when not altered; in more than half of the latter it concerned a dose error (13.7% of all cases). POM prescriptions of patients of 40–65 years had a significantly lower chance of modification compared with those of younger people (OR = 0.74 [0.64–0.86]). With respect to medication-class, we found a higher chance of POM modifications in the respiratory domain (OR = 1.48 [1.23-1.79]) and a decreased chance for nervous system POMs (OR = 0.71 [0.61–0.83]). With regard to prescriber-related determinants modifications were found three times more often in non printed prescriptions than in printed ones (OR = 3.30 [2.90-3.75]). Compared with prescriptions by the patient's own GP, prescriptions of specialists (OR = 1.82 [1.57-2.11]), other GP's (OR = 1.49 [1.02-2.17]) and other prescribers such as dentists and midwives (OR = 1.95 [1.06-3.57]) gave a higher probability of prescription modifications. When a GP had no on-line access to the computer of the pharmacy the chance of a

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science. Abhijit Chakraborty. Articles written in Journal of Earth System Science. Volume 114 Issue 3 June 2005 pp 275-286. Significance of transition between Talchir Formation and Karharbari Formation in Lower Gondwana basin evolution — A study in West Bokaro Coal basin, ...

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science. Bibhuti Gogoi. Articles written in Journal of Earth System Science. Volume 123 Issue 5 July 2014 pp 959-987. Geochemical constraints on the evolution of mafic and felsic rocks in the Bathani volcanic and volcano-sedimentary sequence of Chotanagpur Granite Gneiss ...

Nonmedical Prescription Drug Use: Theory and Policy Implications

OpenAIRE

Gabriele Camera; Bryan Engelhardt

2014-01-01

The illicit nonmedical use of prescription drugs is studied in a model where individuals with imperfectly observable health conditions seek prescription drugs for either medical or nonmedical reasons. The equilibrium number of medical and nonmedical users is endogenous and depends on economic and non-economic barriers to drugs consumption, such as pricing, health care costs, refill policies, monitoring programs, and the medical community’s prescription standards. The results show policies cen...

Enhancement of CO Evolution by Modification of Ga2O3 with Rare-Earth Elements for the Photocatalytic Conversion of CO2 by H2O.

Science.gov (United States)

Tatsumi, Hiroyuki; Teramura, Kentaro; Huang, Zeai; Wang, Zheng; Asakura, Hiroyuki; Hosokawa, Saburo; Tanaka, Tsunehiro

2017-12-12

Modification of the surface of Ga 2 O 3 with rare-earth elements enhanced the evolution of CO as a reduction product in the photocatalytic conversion of CO 2 using H 2 O as an electron donor under UV irradiation in aqueous NaHCO 3 as a pH buffer, with the rare-earth species functioning as a CO 2 capture and storage material. Isotope experiments using 13 CO 2 as a substrate clearly revealed that CO was generated from the introduced gaseous CO 2 . In the presence of the NaHCO 3 additive, the rare-earth (RE) species on the Ga 2 O 3 surface are transformed into carbonate hydrates (RE 2 (CO 3 ) 3 ·nH 2 O) and/or hydroxycarbonates (RE 2 (OH) 2(3-x) (CO 3 ) x ) which are decomposed upon photoirradiation. Consequently, Ag-loaded Yb-modified Ga 2 O 3 exhibits much higher activity (209 μmol h -1 of CO) than the pristine Ag-loaded Ga 2 O 3 . The further modification of the surface of the Yb-modified Ga 2 O 3 with Zn afforded a selectivity toward CO evolution of 80%. Thus, we successfully achieved an efficient Ag-loaded Yb- and Zn-modified Ga 2 O 3 photocatalyst with high activity and controllable selectivity, suitable for use in artificial photosynthesis.

RADIAL EVOLUTION OF SOLAR WIND TURBULENCE DURING EARTH AND ULYSSES ALIGNMENT OF 2007 AUGUST

International Nuclear Information System (INIS)

D'Amicis, R.; Bruno, R.; Pallocchia, G.; Bavassano, B.; Telloni, D.; Carbone, V.; Balogh, A.

2010-01-01

At the end of 2007 August, during the minimum of solar cycle 23, a lineup of Earth and Ulysses occurred, giving the opportunity to analyze, for the first time, the same plasma sample at different observation points, namely at 1 and 1.4 AU. In particular, it allowed us to study the radial evolution of solar wind turbulence typical of fast wind streams as proposed in a Coordinated Investigation Programme for the International Heliophysical Year. This paper describes both the macrostructure and the fluctuations at small scales of this event. We find that soon after detecting the same fast stream, the Advanced Composition Explorer (ACE) observed a change of magnetic polarity being the interplanetary current sheet located between the orbits of the two spacecraft. Moreover, we observe that the compression region formed in front of the fast stream detected at ACE's location evolves in a fast forward shock at Ulysses' orbit. On the other hand, small-scale analysis shows that turbulence is evolving. The presence of a shift of the frequency break separating the injection range from the inertial range toward lower frequencies while distance increases is a clear indication that nonlinear interactions are at work. Moreover, we observe that intermittency, as measured by the flatness factor, increases with distance. This study confirms previous analyses performed using Helios observations of the same fast wind streams at different heliocentric distances, allowing us to relax about the hypothesis of the stationarity of the source regions adopted in previous studies. Consequently, any difference noticed in the solar wind parameters would be ascribed to radial (time) evolution.

76 FR 51310 - Branded Prescription Drug Fee

Science.gov (United States)

2011-08-18

... Branded Prescription Drug Fee AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of proposed... issue of the Federal Register, the IRS is issuing temporary regulations relating to the branded... business of manufacturing or importing certain branded prescription drugs. The text of the temporary...

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

Science.gov (United States)

Smith, M. Elizabeth; Farah, Martha J.

2011-01-01

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

Automated Prescription of Oblique Brain 3D MRSI

OpenAIRE

Ozhinsky, Eugene; Vigneron, Daniel B.; Chang, Susan M.; Nelson, Sarah J.

2012-01-01

Two major difficulties encountered in implementing Magnetic Resonance Spectroscopic Imaging (MRSI) in a clinical setting are limited coverage and difficulty in prescription. The goal of this project was to completely automate the process of 3D PRESS MRSI prescription, including placement of the selection box, saturation bands and shim volume, while maximizing the coverage of the brain. The automated prescription technique included acquisition of an anatomical MRI image, optimization of the ob...

EVOLUTIONARY TRACKS OF THE CLIMATE OF EARTH-LIKE PLANETS AROUND DIFFERENT MASS STARS

Energy Technology Data Exchange (ETDEWEB)

Kadoya, S.; Tajika, E., E-mail: kadoya@astrobio.k.u-tokyo.ac.jp, E-mail: tajika@eps.s.u-tokyo.ac.jp [Department of Earth and Planetary Science, The University of Tokyo, Faculty of Science Bldg. 1 #711, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 (Japan)

2016-07-10

The climatic evolution of the Earth depends strongly on the evolution of the insolation from the Sun and the amount of the greenhouse gasses, especially CO{sub 2} in the atmosphere. Here, we investigate the evolution of the climate of hypothetical Earths around stars whose masses are different from the solar mass with a luminosity evolution model of the stars, a mantle degassing model coupled with a parameterized convection model of the planetary interiors, and an energy balance climate model of the planetary surface. In the habitable zone (HZ), the climate of the planets is initially warm or hot, depending on the orbital semimajor axes. We found that, in the inner HZ, the climate of the planets becomes hotter with time owing to the increase in the luminosity of the central stars, while, in the outer HZ, it becomes colder and eventually globally ice-covered owing to the decrease in the CO{sub 2} degassing rate of the planets. The orbital condition for maintaining the warm climate similar to the present Earth becomes very limited, and more interestingly, the planet orbiting in the outer HZ becomes globally ice-covered after a certain critical age (∼3 Gyr for the hypothetical Earth with standard parameters), irrespective of the mass of the central star. This is because the critical age depends on the evolution of the planets and planetary factors, rather than on the stellar mass. The habitability of the Earth-like planet is shown to be limited with age even though it is orbiting within the HZ.

EVOLUTIONARY TRACKS OF THE CLIMATE OF EARTH-LIKE PLANETS AROUND DIFFERENT MASS STARS

International Nuclear Information System (INIS)

Kadoya, S.; Tajika, E.

2016-01-01

The climatic evolution of the Earth depends strongly on the evolution of the insolation from the Sun and the amount of the greenhouse gasses, especially CO_2 in the atmosphere. Here, we investigate the evolution of the climate of hypothetical Earths around stars whose masses are different from the solar mass with a luminosity evolution model of the stars, a mantle degassing model coupled with a parameterized convection model of the planetary interiors, and an energy balance climate model of the planetary surface. In the habitable zone (HZ), the climate of the planets is initially warm or hot, depending on the orbital semimajor axes. We found that, in the inner HZ, the climate of the planets becomes hotter with time owing to the increase in the luminosity of the central stars, while, in the outer HZ, it becomes colder and eventually globally ice-covered owing to the decrease in the CO_2 degassing rate of the planets. The orbital condition for maintaining the warm climate similar to the present Earth becomes very limited, and more interestingly, the planet orbiting in the outer HZ becomes globally ice-covered after a certain critical age (∼3 Gyr for the hypothetical Earth with standard parameters), irrespective of the mass of the central star. This is because the critical age depends on the evolution of the planets and planetary factors, rather than on the stellar mass. The habitability of the Earth-like planet is shown to be limited with age even though it is orbiting within the HZ.

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science. B S Marh. Articles written in Journal of Earth System Science. Volume 125 Issue 3 April 2016 pp 539-558. Post-glacial landform evolution in the middle Satluj River valley, India: Implications towards understanding the climate tectonic interactions · Shubhra Sharma S K ...

Preparing Earth Data Scientists for 'the sexiest job of the 21st century'

Science.gov (United States)

Kempler, S. J.

2014-12-01

What Exactly do Earth Data Scientists do, and What do They Need to Know, to do It? There is not one simple answer, but there are many complex answers. Data Science, and data analytics, are new and nebulas, and takes on different characteristics depending on: The subject matter being analyzed, the maturity of the research, and whether the employed subject specific analytics is descriptive, diagnostic, discoveritive, predictive, or prescriptive, in nature. In addition, in a, thus far, business driven paradigm shift, university curriculums teaching data analytics pertaining to Earth science have, as a whole, lagged behind, and/or have varied in approach. This presentation attempts to breakdown and identify the many activities that Earth Data Scientists, as a profession, encounter, as well as provide case studies of specific Earth Data Scientist and data analytics efforts. I will also address the educational preparation, that best equips future Earth Data Scientists, needed to further Earth science heterogeneous data research and applications analysis. The goal of this presentation is to describe the actual need for Earth Data Scientists and the practical skills to perform Earth science data analytics, thus hoping to initiate discussion addressing a baseline set of needed expertise for educating future Earth Data Scientists.

Preparing Earth Data Scientists for 'The Sexiest Job of the 21st Century'

Science.gov (United States)

Kempler, Steven

2014-01-01

What Exactly do Earth Data Scientists do, and What do They Need to Know, to do It? There is not one simple answer, but there are many complex answers. Data Science, and data analytics, are new and nebulas, and takes on different characteristics depending on: The subject matter being analyzed, the maturity of the research, and whether the employed subject specific analytics is descriptive, diagnostic, discoveritive, predictive, or prescriptive, in nature. In addition, in a, thus far, business driven paradigm shift, university curriculums teaching data analytics pertaining to Earth science have, as a whole, lagged behind, andor have varied in approach.This presentation attempts to breakdown and identify the many activities that Earth Data Scientists, as a profession, encounter, as well as provide case studies of specific Earth Data Scientist and data analytics efforts. I will also address the educational preparation, that best equips future Earth Data Scientists, needed to further Earth science heterogeneous data research and applications analysis. The goal of this presentation is to describe the actual need for Earth Data Scientists and the practical skills to perform Earth science data analytics, thus hoping to initiate discussion addressing a baseline set of needed expertise for educating future Earth Data Scientists.

Influence of errors in prescriptions on the security of medicine

Directory of Open Access Journals (Sweden)

Puke K.

2016-01-01

Full Text Available All types of medication errors including missed doses, incorrect dosage forms, time intervals, and routes are essential encumbrances for qualitative pharmaceutical care and security of medicine [1]. Problems related to prescription errors are common in the healthcare profession, and are responsible for significant increase in costs, cases of morbidity and mortality [2]. The aim of the study was to analyze the common errors in prescriptions which were received in pharmacies and their effect on the security of medicine. Retrospective study was conducted between December 2013 and January 2014 in the pharmacy of Riga, Latvia. Prescriptions were analyzed to identify errors in Inscriptio, Praescriptio and the Signatura part. Of 200 prescriptions, only 14 (7% were filled correctly according to the legislative requirements in Latvia. The most common drug therapeutic class in the prescriptions was non-steroidal anti-inflammatory drugs (NSAID and other analgesics (21.1%. Unclear handwriting was observed in more than one third of all studied prescriptions (n=72; 36.0%. Mean age values of physicians were higher, but not significantly different, in the unclear compared to clear prescriptions, 59.5 ± 8.5 vs. 57.8 ± 10.6, respectively (p=0.253. Omission of the quantity of drug in the prescription part was the most frequent type of the error (n=112, 56.0%. High level of incorrect prescriptions was found during the period of study in the pharmacy. Overall, approximately 27% of prescriptions had significant failures, which could negatively affect therapeutic effect and safety of drug use.

Influence of pharmacists expertise on physicians prescription ...

African Journals Online (AJOL)

Purpose: To explore the influence of pharmacist factors on prescription decisions of physicians. Methods: A survey of literature was carried out across online databases and 12 relevant articles were identified. The influence of pharmacist factors on physician prescription decisions was identified in the articles. A conceptual ...

Prescription Drug Plan Formulary, Pharmacy Network, and P...

Data.gov (United States)

U.S. Department of Health & Human Services — These public use files contain formulary, pharmacy network, and pricing data for Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug Plans...

Antibiotic Prescription in Danish General Practice

DEFF Research Database (Denmark)

Sydenham, Rikke Vognbjerg; Plejdrup Hansen, Malene; Pedersen, Line Bjørnskov

2016-01-01

1. Background & Aim The overall aim of the project is to describe antibiotic consumption in Danish general practice with emphasis on specific types of antibiotics. The project will shed light on the impact of microbiological diagnostic methods (MDM) on the choice of antibiotic and the project...... will explore how the GPs prescription behaviour is influenced by selected factors. Antibiotics are essential when treating potentially lethal infections. An increasing development of resistant bacteria is considered one of the primary threats to public health. The majority of antibiotics (90%) are prescribed...... from general practice. The prescription of broad-spectrum antibiotics can cause unnecessary side effects for the individual and increases the risk of development of bacteria resistant to antibiotic treatment. Both the prescription of broad-spectrum antibiotics and the level of resistant bacteria...

Prescription Drug Abuse: From Epidemiology to Public Policy

OpenAIRE

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

2014-01-01

Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a spe...

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science. Ferid Dhahri. Articles written in Journal of Earth System Science. Volume 126 Issue 7 October 2017 pp 104. The role of E–W basement faults in the Mesozoic geodynamic evolution of the Gafsa and Chotts basins, south-central Tunisia · Dorra Tanfous Amri Ferid Dhahri ...

Automated Prescription of Oblique Brain 3D MRSI

Science.gov (United States)

Ozhinsky, Eugene; Vigneron, Daniel B.; Chang, Susan M.; Nelson, Sarah J.

2012-01-01

Two major difficulties encountered in implementing Magnetic Resonance Spectroscopic Imaging (MRSI) in a clinical setting are limited coverage and difficulty in prescription. The goal of this project was to completely automate the process of 3D PRESS MRSI prescription, including placement of the selection box, saturation bands and shim volume, while maximizing the coverage of the brain. The automated prescription technique included acquisition of an anatomical MRI image, optimization of the oblique selection box parameters, optimization of the placement of OVS saturation bands, and loading of the calculated parameters into a customized 3D MRSI pulse sequence. To validate the technique and compare its performance with existing protocols, 3D MRSI data were acquired from 6 exams from 3 healthy volunteers. To assess the performance of the automated 3D MRSI prescription for patients with brain tumors, the data were collected from 16 exams from 8 subjects with gliomas. This technique demonstrated robust coverage of the tumor, high consistency of prescription and very good data quality within the T2 lesion. PMID:22692829

Pervasive orbital eccentricities dictate the habitability of extrasolar earths.

Science.gov (United States)

Kita, Ryosuke; Rasio, Frederic; Takeda, Genya

2010-09-01

The long-term habitability of Earth-like planets requires low orbital eccentricities. A secular perturbation from a distant stellar companion is a very important mechanism in exciting planetary eccentricities, as many of the extrasolar planetary systems are associated with stellar companions. Although the orbital evolution of an Earth-like planet in a stellar binary system is well understood, the effect of a binary perturbation on a more realistic system containing additional gas-giant planets has been very little studied. Here, we provide analytic criteria confirmed by a large ensemble of numerical integrations that identify the initial orbital parameters leading to eccentric orbits. We show that an extrasolar earth is likely to experience a broad range of orbital evolution dictated by the location of a gas-giant planet, which necessitates more focused studies on the effect of eccentricity on the potential for life.

Prescription Writing Errors of Midwifery Students in Common Gynecological problems

Directory of Open Access Journals (Sweden)

Serveh Parang

2014-04-01

Full Text Available Background and aim: Giving improper prescriptions is common among medical practitioners, mostly graduates, in most communities even developed countries. So far, to our knowledge, no study has been conducted on prescription writing of graduate midwifery students. Therefore, this study aimed to detect prescription writing errors of midwifery students in common gynecological problems. Methods: In this descriptive cross-sectional study, 56 bachelor midwifery students, who had passed the theoretical and clinical courses of gynecology, were evaluated by Objective Structured Clinical Examination (OSCE. A demographic questionnaire and a standard checklist for writing the prescriptions and medications were used for data collection. SPSS Version 16 was used to carry out descriptive statistics. Findings: Most of the students were single, with the mean age of 23.0±1.7 years. Most errors were related to not recording the patients’ age and sex, diagnosis, chief complaint, and the prescriber’s name (observed in less than 10% of the prescriptions. The complete dosage schedule and drug name were stated only in 1.8±4.8 and 14±18.6 of prescriptions, respectively. In more than 93% of the cases, route of use and treatment duration were not recorded. Conclusion: According to the results, the number of prescription errors of midwifery students was high. Therefore, it is recommended to run educational courses on prescription writing skills (e.g. writing prescriptions based on World Health Organization (WHO guidelines for the midwifery students.

Models of the earth's core

Science.gov (United States)

Stevenson, D. J.

1981-01-01

Combined inferences from seismology, high-pressure experiment and theory, geomagnetism, fluid dynamics, and current views of terrestrial planetary evolution lead to models of the earth's core with five basic properties. These are that core formation was contemporaneous with earth accretion; the core is not in chemical equilibrium with the mantle; the outer core is a fluid iron alloy containing significant quantities of lighter elements and is probably almost adiabatic and compositionally uniform; the more iron-rich inner solid core is a consequence of partial freezing of the outer core, and the energy release from this process sustains the earth's magnetic field; and the thermodynamic properties of the core are well constrained by the application of liquid-state theory to seismic and labroatory data.

Bodily differences between Cold- and Heat-prescription groups in Sasang medicine

Directory of Open Access Journals (Sweden)

Young Joo Park

2016-06-01

Conclusion: In the SY-type men, the chest circumference was significantly greater in the Heat-prescription group compared to the Cold-prescription group. In the TE-type men, the rib-to-pelvic circumference ratio was significantly higher in the Heat-prescription group than in the Cold-prescription group.

[Analysis on traditional Chinese medicine prescriptions treating cancer-related anorexia syndrome based on grey system theory combined with multivariate analysis method and discovery of new prescriptions].

Science.gov (United States)

Chen, Song-Lin; Chen, Cong; Zhu, Hui; Li, Jing; Pang, Yan

2016-01-01

Cancer-related anorexia syndrome (CACS) is one of the main causes for death at present as well as a syndrome seriously harming patients' quality of life, treatment effect and survival time. In current clinical researches, there are fewer reports about empirical traditional Chinese medicine(TCM) prescriptions and patent prescriptions treating CACS, and prescription rules are rarely analyzed in a systematic manner. As the hidden rules are not excavated, it is hard to have an innovative discovery and knowledge of clinical medication. In this paper, the grey screening method combined with the multivariate statistical method was used to build the ″CACS prescriptions database″. Based on the database, totally 359 prescriptions were selected, the frequency of herbs in prescription was determined, and commonly combined drugs were evolved into 4 new prescriptions for different syndromes. Prescriptions of TCM in treatment of CACS gave priority to benefiting qi for strengthening spleen, also laid emphasis on replenishing kidney essence, dispersing stagnated liver-qi and dispersing lung-qi. Moreover, interdependence and mutual promotion of yin and yang should be taken into account to reflect TCM's holism and theory for treatment based on syndrome differentiation. The grey screening method, as a valuable traditional Chinese medicine research-supporting method, can be used to subjectively and objectively analyze prescription rules; and the new prescriptions can provide reference for the clinical use of TCM for treating CACS and the drug development. Copyright© by the Chinese Pharmaceutical Association.

Direct-to-consumer advertising of prescription drugs.

Science.gov (United States)

Frosch, Dominick L; Grande, David

2010-01-01

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

21 CFR 1306.22 - Refilling of prescriptions.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Refilling of prescriptions. 1306.22 Section 1306.22 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS Controlled... 75 FR 16308, Mar. 31, 2010, § 1306.22 was revised, effective June 1, 2010. For the convenience of the...

Gamma knife radio-surgery in meningiomas: decisive variables in the dose prescription during 14 years

International Nuclear Information System (INIS)

Dominguez O, X.; Diaz A, P.; Toledo B, V.; Zazueta L, F.

2010-09-01

A comparative study is presented among the variables of dose prescription in twelve cases of treated meningiomas from 1997 to 2009 in the Gamma Knife Unit of the Hospital San Javier. An evolution is observed in the definition of the treatment volumes, collimators election and matrix of dose calculation, this evolution has been due so much to the technological advance associated to the image acquisition systems: Computerized axial tomography, Images by magnetic resonance and Angiography by digital subtraction, as well as to the indexes adoption that are used to qualify among different treatment plans. The differences among the analyzed periods demonstrate a favorable learning curve that have influenced contributing to a treatment with a minor irradiated volume due to the application of theoretical models used in this installation, attenuating the risk of peripheral unexpected complications to the treated volume. (Author)

[Inappropriate prescription in older patients: the STOPP/START criteria].

LENUS (Irish Health Repository)

Delgado Silveira, Eva

2009-09-01

Older people are a heterogeneous group of patients, often with multiple comorbidities for which they are prescribed a large number of drugs, leading to an increased risk of adverse drug reactions (ADR) and drug interactions. This risk is compounded by physiological age-related changes in physiology, changes in drug pharmacokinetics and pharmacodynamics, as well as by disease-related, functional and social issues. Inappropriate prescription of drugs is common in the older individuals and contributes to the increased risk of ADR. Several tools have been developed to detect potentially inappropriate prescription, the most frequently used in Spain being Beers\\' criteria. However, the value of these criteria is limited, especially as they were developed in a different healthcare system. In this article, the Spanish version of a new tool to detect potentially inappropriate prescriptions-STOPP (Screening Tool of Older Person\\'s Prescriptions) and START (Screening Tool to Alert doctors to Right i.e. appropriate, indicated Treatment) criteria-is presented. The creation, development, reliability, and use of these criteria in routine practice is described and discussed. These criteria have shown better sensitivity than Beers\\' criteria in detecting prescription problems and have the added value of being able to detect not only inappropriate prescription of some drugs, but also the omission of well indicated drugs. The STOPP\\/START criteria could become a useful screening tool to improve prescription in older people.

Prescription Drug Monitoring Programs and Other Interventions to Combat Prescription Opioid Abuse

Directory of Open Access Journals (Sweden)

Bharath Chakravarthy

2012-12-01

Full Text Available The Center for Disease Control and Prevention (CDC has published significant data and trendsrelated to opioid prescription pain relievers (OPR. In 2008, 20,044 deaths were attributedto prescription drug overdose of which 14,800 (73.8% were due to OPR, an amount greaterthan the number of overdose deaths from heroin and cocaine combined. The majority of thesedeaths were unintentional. Between 1999-2008, overdose deaths from OPR increased almostfour-fold. Correspondingly, sales of OPR were four times greater in 2010 than in 1999. Mostsignificant to emergency physicians is the estimate that 39% of all opioids prescribed, administeredor continued come from the emergency department (ED. We present findings from theCDC’s Morbidity and Mortality Weekly Report (MMWR with commentary on current recommendationsand policies for curtailing the OPR epidemic.1

Syndication of the earth system: the future of geoscience?

International Nuclear Information System (INIS)

Elliott, Scott M.; Hanson, Howard P.

2003-01-01

Current global change policy debate reverberates around the polarized extremes of civilization-level cooperation through treaties as a mitigation tactic, on the one hand, and a wait-and-see approach that may lead to a climatic tragedy of the commons, on the other. Meanwhile, energy technology research is rapidly generating a perception that it will be possible to tune the earth system via carbon sequestration and other types of biogeochemical engineering. The consequences of this potential for planetary management, based on provincial self-interest, include the transition of the earth sciences into a security industry involving proprietary scientific knowledge bases of biogeochemical cycling and the evolution of a climate-design brokerage dominated by military/industrial interests. As the dominant political powers perceive the potential for planetary engineering and consider implementation, the global economy will adjust to exploit new opportunities, perceptions of which will be determined by the quality of system simulations. The growth of a viable international climate-design community will profoundly influence the trajectory of the earth system by providing either the illusion or the reality of predictability. Although this process will be chaotic at first, the probability of stabilization will ultimately be enhanced because the vast resources of the military/industrial sector will become involved. These concepts are disturbingly familiar in that they acknowledge the pervasion of competition and conflict in human technological affairs. However, they are consistent with approaches used in thermodynamics, ecological energetics, behavioral evolution, economics, and interdisciplinary climate science to describe collectively the evolution of the earth system. This paper argues that the perception that the climate can be regulated inexpensively will create an economic driving force for international cartel-style management of the total earth system. That is, the earth

Using prescription monitoring program data to characterize out-of-pocket payments for opioid prescriptions in a state Medicaid program.

Science.gov (United States)

Hartung, Daniel M; Ahmed, Sharia M; Middleton, Luke; Van Otterloo, Joshua; Zhang, Kun; Keast, Shellie; Kim, Hyunjee; Johnston, Kirbee; Deyo, Richard A

2017-09-01

Out-of-pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon. To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out-of-pocket by individuals in the Oregon Medicaid program. Cross-sectional analysis using Oregon Medicaid administrative claims and PDMP data (2012 to 2013). Continuously enrolled nondually eligible Medicaid beneficiaries who could be linked to the PDMP with two opioid fills covered by Oregon Medicaid. Patient characteristics and fill characteristics for opioid fills that lacked a Medicaid pharmacy claim. Fill characteristics included opioid name, type, and association with indicators of high-risk opioid use. A total of 33 592 Medicaid beneficiaries filled a total of 555 103 opioid prescriptions. Of these opioid fills, 74 953 (13.5%) could not be matched to a Medicaid claim. Hydromorphone (30%), fentanyl (18%), and methadone (15%) were the most likely to lack a matching claim. The 3 largest predictors for missing claims were opioid fills that overlapped with other opioids (adjusted odds ratio [aOR] 1.37; 95% confidence interval [CI], 1.34-1.4), long-acting opioids (aOR 1.52; 95% CI, 1.47-1.57), and fills at multiple pharmacies (aOR 1.45; 95% CI, 1.39-1.52). Prescription opioid fills that were likely paid out-of-pocket were common and associated with several known indicators of high-risk opioid use. Copyright © 2017 John Wiley & Sons, Ltd.

Biological modulation of planetary atmospheres: The early Earth scenario

Science.gov (United States)

Schidlowski, M.

1985-01-01

The establishment and subsequent evolution of life on Earth had a profound impact on the chemical regime at the planet's surface and its atmosphere. A thermodynamic gradient was imposed on near-surface environments that served as the driving force for a number on important geochemical transformations. An example is the redox imbalance between the modern atmosphere and the material of the Earth's crust. Current photochemical models predict extremely low partial pressures of oxygen in the Earth's prebiological atmosphere. There is widespread consensus that any large-scale oxygenation of the primitive atmosphere was contingent on the advent of biological (autotrophic) carbon fixation. It is suggested that photoautotrophy existed both as a biochemical process and as a geochemical agent since at least 3.8 Ga ago. Combining the stoichiometry of the photosynthesis reaction with a carbon isotope mass balance and current concepts for the evolution of the stationary sedimentary mass as a funion of time, it is possible to quantify, the accumulation of oxygen and its photosynthetic oxidation equivalents through Earth history.

A Theoretical Approach to Electronic Prescription System: Lesson Learned from Literature Review

Science.gov (United States)

Samadbeik, Mahnaz; Ahmadi, Maryam; Hosseini Asanjan, Seyed Masoud

2013-01-01

Context The tendency to use advanced technology in healthcare and the governmental policies have put forward electronic prescription. Electronic prescription is considered as the main solution to overcome the major drawbacks of the paper-based medication prescription, such as transcription errors. This study aims to provide practical information concerning electronic prescription system to a variety of stakeholders. Evidence Acquisition In this review study, PubMed, ISI Web of Science, Scopus, EMBASE databases, Iranian National Library Of Medicine (INLM) portal, Google Scholar, Google and Yahoo were searched for relevant English publications concerning the problems of paper-based prescription, and concept, features, levels, benefits, stakeholders and standards of electronic prescription system. Results There are many problems with the paper prescription system which, according to studies have jeopardized patients’ safety and negatively affected the outcomes of medication therapy. All of these problems are remedied through the implementation of e-prescriptions. Conclusions The sophistication of electronic prescription and integration with EHR will become a reality, if all its stakeholders collaborate in developing fast and secure electronic prescription systems. It is plausible that the required infrastructure should be provided for implementation of the national integrated electronic prescription systems in countries without the system. Given the barriers to the implementation and use, policymakers should consider multiple strategies and offer incentives to encourage e-prescription initiatives. This will result in widespread adoption of the system. PMID:24693376

The mental health consequences of nonmedical prescription drug use among adolescents.

Science.gov (United States)

Ali, Mir M; Dean, David; Lipari, Rachel; Dowd, William N; Aldridge, Arnie P; Novak, Scott P

2015-03-01

Nonmedical prescription drug use is estimated to be the second most abused category of drugs after marijuana among adolescents. Prescription drugs can be highly addictive and prolonged use can produce neurological changes and physiological dependence and could result in adverse mental health outcomes. This topic is largely unexplored, as current knowledge of possible mechanisms of the linkage between adverse mental health consequences and prescription drug misuse is limited. This study explores the relationship between nonmedical use of prescription drugs and depression outcomes among adolescents. Given their complex and confounded relationship, our purpose is to better understand the extent to which nonmedical use of prescription drugs is an antecedent of depressive episodes. Using data from the 2008-2012 National Survey on Drug Use and Health, the study employs a propensity score matching methodology to ascertain whether nonmedical use of prescription drugs is linked to major depressive episodes among adolescents. The results document a positive relationship between nonmedical prescription drug use and major depressive episodes among adolescents. Specifically, the results indicate that adolescents who used prescription drugs non-medically are 33% to 35% more likely to experience major depressive episodes compared to their non-abusing counterparts. This provides additional evidence about the potential public health consequences of misuse of prescription drugs on adverse mental health outcomes. Given the significant increased risk of major depressive episode among adolescents who use prescription drugs nonmedically, it seems that the prevention of nonmedical prescription drug use warrants the utilization of both educational and public health resources. An important area for future research is to understand how any policy initiatives in this area must strike a balance between the need to minimize the misuse of prescription drugs and the need to ensure access for

Emergency department discharge prescription interventions by emergency medicine pharmacists.

Science.gov (United States)

Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

2013-02-01

We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

Evolution of Electron Transport Chains During the Anaerobic to Aerobic Transition on Early Earth

Science.gov (United States)

Sepúlveda, R.; Ortiz, R.; Holmes, D. S.

2015-12-01

Sepulveda, R., Ortiz R. and Holmes DS. Center for Bioinformatics and Genome Biology, Fundacion Ciencia y Vida, and Facultad de Ciencias Biologicas, Universidad Andres Bello, Santiago, Chile.According to several models, life emerged on earth in an anoxic environment where oxygen was not available as a terminal electron acceptor for energy generating reactions. After the Great Oxidation Event (GOE) about 2.4 billion years ago, or perhaps even before the GOE, oxygen became the most widespread and efficient terminal electron acceptor and was accompanied by the evolution of a number of redox proteins that could deliver electrons to reduce oxygen to water. Where did these proteins come from? One hypothesis is that they evolved by the neofunctionalization of previously existing redox proteins that had been used in anaerobic conditions as terminal electron donors to reduce compounds such as perchlorate, nitric oxide or iron. We have used a number of bioinformatic tools to explore a large number of genomes looking for discernable signals of such redeployment of function. A Perl pipeline was designed to detect sequence similarity, conserved gene context, remote homology detection, identification of domains and functional evolution of electron carrier proteins from extreme acidophiles, including the small blue copper protein rusticyanin (involved in FeII oxidation), cytochrome oxidase subunit II and quinol-dependent nitric oxide reductase (qNOR). The protein folds and copper binding sites of rusticyanin are conserved in cytochrome oxidase aa3 subunit II, a protein complex that is responsible for the final passage of electrons to reduce oxygen. Therefore, we hypothesize that rusticyanin, cytochrome oxidase II and qNOR are evolutionarily related. Acknowledgments: Fondecyt 1130683.

Doctor Shopping Behavior and the Diversion of Prescription Opioids.

Science.gov (United States)

Simeone, Ronald

2017-01-01

"Doctor shopping" as a means of prescription opioid diversion is examined. The number and percentage of prescriptions and morphine-equivalent milligrams diverted in this manner are estimated by state and molecule for the period 2008-2012. Eleven billion prescriptions with unique patient, doctor, and pharmacy identifiers were used to construct diversion "events" that involved between 1 and 6 unique doctors and between 1 and 6 unique pharmacies. Diversion thresholds were established based on the probability of each contingency. A geographically widespread decline occurred between 2008 and 2012. The number of prescriptions diverted fell from approximately 4.30 million (1.75% of all prescriptions) in 2008 to approximately 3.37 million (1.27% of all prescriptions) in 2012, and the number of morphine-equivalent milligrams fell from approximately 6.55 metric tons (2.95% of total metric tons) in 2008 to approximately 4.87 metric tons (2.19% of total metric tons) in 2012. Diversion control efforts have likely been effective. But given increases in opioid-related deaths, opioid-related drug treatment admissions, and the more specific resurgence of heroin-related events, it is clear that additional public health measures are required.

Advancements in medium and high resolution Earth observation for land-surface imaging: Evolutions, future trends and contributions to sustainable development

Science.gov (United States)

Ouma, Yashon O.

2016-01-01

Technologies for imaging the surface of the Earth, through satellite based Earth observations (EO) have enormously evolved over the past 50 years. The trends are likely to evolve further as the user community increases and their awareness and demands for EO data also increases. In this review paper, a development trend on EO imaging systems is presented with the objective of deriving the evolving patterns for the EO user community. From the review and analysis of medium-to-high resolution EO-based land-surface sensor missions, it is observed that there is a predictive pattern in the EO evolution trends such that every 10-15 years, more sophisticated EO imaging systems with application specific capabilities are seen to emerge. Such new systems, as determined in this review, are likely to comprise of agile and small payload-mass EO land surface imaging satellites with the ability for high velocity data transmission and huge volumes of spatial, spectral, temporal and radiometric resolution data. This availability of data will magnify the phenomenon of ;Big Data; in Earth observation. Because of the ;Big Data; issue, new computing and processing platforms such as telegeoprocessing and grid-computing are expected to be incorporated in EO data processing and distribution networks. In general, it is observed that the demand for EO is growing exponentially as the application and cost-benefits are being recognized in support of resource management.

An audit of dental prescriptions between clinics and dental laboratories.

Science.gov (United States)

Stewart, C A

2011-08-12

To discover the quality of written instructions from dentists to dental technicians and the nature of non-compliant prescriptions. An audit of laboratory prescription compliance was conducted within an NHS Trust Dental Teaching Hospital to determine the level of communication between dentists and dental technicians. One hundred and fifty prescriptions were audited from dental undergraduates and qualified dentists throughout the different departments. A total of two-thirds of prescriptions were considered non-compliant and failed to meet relevant ethical and legal guidelines. This problem was seen throughout all departments and at all professional levels. A breakdown in communication between dentists and technicians through the use of prescriptions is evident even within a close working environment.

WAVE TECTONICS OF THE EARTH

Directory of Open Access Journals (Sweden)

Tatiana Yu. Tveretinova

2010-01-01

Full Text Available In the Earth's lithosphere, wavy alternation of positive and negative heterochronous structures is revealed; such structures are variable in ranks and separated by vergence zones of fractures and folds. In the vertical profile of the lithosphere, alternating are layers characterized by relatively plastic or fragile rheological properties and distinguished by different states of stress. During the Earth’s evolution, epochs of compression and extension are cyclically repeated, including planetary-scale phenomena which are manifested by fluctuating changes of the planet’s volume. Migration of geological and geophysical (geodynamic processes takes place at the Earth's surface and in its interior. The concept of the wave structure and evolution of the Earth's lithosphere provides explanations to the abovementioned regularities. Wavy nature of tectonic structures of the lithosphere, the cyclic recurrence of migration and geological processes in space and time can be described in terms of the multiple-order wave geodynamics of the Earth's lithosphere that refers to periodical variations of the state of stress. Effects of structure-forming tectonic forces are determined by «interference» of tangential and radial stresses of the Earth. The tangential stresses, which occur primarily due to the rotational regime of the planet, cause transformations of the Earth’s shape, redistributions of its substance in depths, the westward drift of the rock mass in its upper levels, and changes of structural deformation plans. The radial stresses, which are largely impacted by gravity, determine the gravitational differentiation of the substance, vertical flattening and sub-horizontal flow of the rock masses, and associated fold-rupture deformation. Under the uniform momentum geodynamic concept proposed by [Vikulin, Tveritinova, 2004, 2005, 2007, 2008], it is possible to provide consistent descriptions of seismic and volcanic, tectonic and geological processes

Retapamulin prescriptions and monitored off-label use.

Science.gov (United States)

Mundy, Linda M; Sampson, Tim; Logie, John W

2014-08-01

Retapamulin, a topical pleuromutilin that selectively inhibits bacterial protein synthesis, is approved for treatment of impetigo and secondarily infected traumatic lesions in adults and in children older than 9 months of age. A 5-year study was conducted to monitor prescription use in children younger than 9 months of age. Annual prescription events were monitored in the UK Clinical Practice Research Datalink (CPRD) and the Clinformatics™ DataMart Multiplan (IMPACT), a product of OptumInsight Life Sciences, Inc. (Eden Prairie, MN, USA), from the USA. In the CPRD, of 148 prescriptions, three (2 %) were identified in children aged less than 9 months between years 2008 and 2011. In IMPACT, of 59,210 claims for retapamulin in children, 1,951 (3.3 %) were categorized as definitive, or uncertain for, less than 9 months of age between 2007 and 2011. Retapamulin prescription events in children aged less than 9 months were relatively low compared with other recent estimations of off-label pediatric medicines. Our report provides a framework for future investigations and discussions that may facilitate off-label reporting schemes and promote pediatric drug safety.

Evolution of matter and energy on a cosmic and planetary scale

International Nuclear Information System (INIS)

Taube, M.

1985-01-01

This book covers the following topics: matter and energy; the interplay of elementary particles and elementary forces; the universe; how is it observed here and now; its past and possible future; the origin and nuclear evolution of matter; chemical evolution and the evolution of life; the cosmic phenomena; the eternal cycle of matter on the earth; the flow of energy on the earth; the biosphere; the coupling of matter and the flow of free energy; is the future development of mankind on this planet possible, and the distant future of mankind: terrestrial or cosmic

Towards Prescriptive Analytics in Cyber-Physical Systems

DEFF Research Database (Denmark)

Siksnys, Laurynas

solving capability allowing to formulate optimization problems using SQL-like queries and to solve them “inside a database”, (4) a real-time data management architecture for processing instances of flexibility and prescription models under (soft or hard) timing constraints, and (5) a graphical user...... of (1) a unified multi-dimensional schema for storing flexibility and prescription models (and related data), (2) techniques to incrementally aggregate flexibility model instances and disaggregate prescription model instances, (3) a database management system (DBMS) with built-in optimization problem...... the introduced concepts are applicable in the real world. We believe that all this contribution makes a significant step towards developing planning-capable CPSs in the future....

Prescription Drug Abuse

Science.gov (United States)

... were prescribed to someone else or if your child is already taking other prescription medications. Set rules. Let your teen know that it's not OK to share medications with others — or to take drugs prescribed for others. Emphasize the importance of taking the prescribed dose and talking with ...

Opioid prescriptions before and after high-energy trauma

DEFF Research Database (Denmark)

Zwisler, Stine T; Hallas, Jesper; Larsen, Morten S

2015-01-01

OBJECTIVE: To describe the legal use of opioids in adult patients before and after high-energy trauma. DESIGN: The study was a retrospective database study. SETTING: Clinical care outside hospitals. PATIENTS: All patients who suffered high-energy trauma and were brought to Odense University...... Hospital (OUH), Denmark, in 2007 and 2008 were retrieved from the trauma database. These patients were linked with data on opioid use from the regional prescription database. In all, 938 patients were included. MAIN OUTCOME MEASURE: Redemption of opioid prescription during the 6 months prior...... to a multitrauma or redemption of two or more prescriptions for opioids 6 months or later after a multitrauma. RESULTS: Of the 938 patients brought to OUH with severe trauma within the study period, 61 patients died (7 percent) and six of these had redeemed prescriptions for opioids within 6 months prior...

Influence of pharmaceutical marketing on prescription practices of physicians.

Science.gov (United States)

Narendran, Roshni; Narendranathan, M

2013-01-01

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

World resources and the development of the earth's surface

International Nuclear Information System (INIS)

Sasaki, A.; Ishihara, S.; Seki, Y.

1985-01-01

This text is an examination of economic (or ore) geology, and engineering geology. Using case studies of Japan and continental North America, this work presents a geological and geochemical summary of ore-forming processes along with discussions of basic principles and approaches to modern engineering geology. Emphasizes the relationship between fossil fuel resources and the evolution of the Earth's crust. Contents - WORLD RESOURCES. The Geochemistry of Metallogenesis. The Geochemistry of Fossil Fuel Deposit. Global Evolution and the Formation of Mineral Deposits. The Development of Continents and Island Arcs and the Formation of Mineral Deposits. DEVELOPMENT OF THE EARTH'S SURFACE. Development of the Earth's Surface and Engineering Geology. Engineering Geology Methods. Features of the Ground and Bedrock in Japan. Engineering Geology - A Case Study. Geology and the Environment - Case Studies. INDEX. Principal World-Wide Metal Deposits (inside front cover). Principal World-Wide Coal, Petroleum and Uranium Deposits (inside back cover)

The Magnetic Field of Planet Earth

DEFF Research Database (Denmark)

Hulot, G.; Finlay, Chris; Constable, C. G.

2010-01-01

The magnetic field of the Earth is by far the best documented magnetic field of all known planets. Considerable progress has been made in our understanding of its characteristics and properties, thanks to the convergence of many different approaches and to the remarkable fact that surface rocks...... yr) to the longest (virtually the age of the Earth) time scales are finally reviewed, underlining the respective roles of the magnetohydodynamics at work in the core, and of the slow dynamic evolution of the planet as a whole....

A journey through Earth climates

International Nuclear Information System (INIS)

Ramstein, Gilles; Brunet, Michel

2015-01-01

The author proposes a history of climates all along Earth's history, describes how cold and warm periods have been alternating during these billions of years. He also tries to highlight lessons learned from this long evolution of climate in order to better understand the current global warming. He discusses whether this disruption is unique in Earth's history, and how it threatens our environment and therefore our survival. The chapters describe how Earth could escape a global glaciation, the thermal regulation by greenhouse effect gases in a world without oxygen, the empowerment of oxygen and the first thermal accident, a new oxygenated and warm world, the second accident or how Earth entered and escaped from periods of total glaciation, the possible stabilisation, the succession of deregulations, crisis and extinctions, the slow way down to the cold, the various paleo-indicators during the Quaternary, the high frequency oscillations of climate during the last million of years, and the uncertain projections

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

Science.gov (United States)

2010-03-16

...] Prescription Drug User Fee Act; Public Meeting AGENCY: Food and Drug Administration, HHS. ACTION: Notice of... Prescription Drug User Fee Act (PDUFA). The legislative authority for PDUFA expires in September 2012. At that time, new legislation will be required for FDA to continue collecting user fees for the prescription...

Antihypertensive use, prescription patterns, and cost of medications ...

African Journals Online (AJOL)

Antihypertensive use, prescription patterns, and cost of medications in a Teaching Hospital in Lagos, Nigeria. ... Conclusions: Antihypertensive prescription pattern was in accordance with the seventh report of Joint National Committee on Prevention, Detection, Evaluation, and Treatment of high blood pressure.

Tamper-resistant prescription forms for narcotics in France:should we generalise them?

Science.gov (United States)

Daveluy, Amélie; Sauvaget, Lucie; Bastien, Angela; Lapeyre-Mestre, Maryse; Collin, Cédric; Richard, Nathalie; Haramburu, Françoise

2018-03-27

In France, prescription of narcotics must be written on a tamper-resistant prescription form with specific technical particularities. Dosage and daily dose of medicines shall be written out entirely in letters. These prescription forms are also mandatory for buprenorphine, clorazepate, clonazepam, tianeptine, buccal midazolam and zolpidem owing to traffic, abuse or diversion. In 2012, to assess the use of standard and tamper-resistant prescription forms and the acceptability of the generalization of the latter to all medicines, a national opinion survey was performed, with a postal questionnaire, within 3 randomized samples of 1,500 prescribers (physicians, dentists and midwives). Of the 403 participating prescribers (participation rate of 26.8%), 373 were physicians, 14 dentists and 16 midwives. Tamper-resistant prescription forms were used by 76.2% of prescribers, but only by 5.1% in a computerised version, whereas, for standard prescription forms, 61% used computer assisted prescription software. The main reason was the inability of the prescription software to print these forms or to respect the mandatory prescription rules for narcotics. Theft and falsification of prescriptions had ever occurred (working life). Most prescribers (62.5%) were against the generalization of tamper-resistant prescription forms. Those in favour were for a generalization to all medicines (65%) and not only to psychotropic agents. Generalization of tamper-resistant prescription forms is not a consensual solution to prevent medicines' diversion. Some prescribers alluded to the possibility of dematerialisation and electronic transmission of prescription forms, which could avoid theft, forgery or falsification. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

NASA's Earth Science Data Systems Standards Endorsement Process

National Research Council Canada - National Science Library

Ullman, Richard E; Enloe, Yonsook

2005-01-01

Starting in January 2004, NASA instituted a set of internal working groups to develop ongoing recommendations for the continuing broad evolution of Earth Science Data Systems development and management within NASA...

Stable numerical method in computation of stellar evolution

International Nuclear Information System (INIS)

Sugimoto, Daiichiro; Eriguchi, Yoshiharu; Nomoto, Ken-ichi.

1982-01-01

To compute the stellar structure and evolution in different stages, such as (1) red-giant stars in which the density and density gradient change over quite wide ranges, (2) rapid evolution with neutrino loss or unstable nuclear flashes, (3) hydrodynamical stages of star formation or supernova explosion, (4) transition phases from quasi-static to dynamical evolutions, (5) mass-accreting or losing stars in binary-star systems, and (6) evolution of stellar core whose mass is increasing by shell burning or decreasing by penetration of convective envelope into the core, we face ''multi-timescale problems'' which can neither be treated by simple-minded explicit scheme nor implicit one. This problem has been resolved by three prescriptions; one by introducing the hybrid scheme suitable for the multi-timescale problems of quasi-static evolution with heat transport, another by introducing also the hybrid scheme suitable for the multi-timescale problems of hydrodynamic evolution, and the other by introducing the Eulerian or, in other words, the mass fraction coordinate for evolution with changing mass. When all of them are combined in a single computer code, we can compute numerically stably any phase of stellar evolution including transition phases, as far as the star is spherically symmetric. (author)

Detection and correction of prescription errors by an emergency department pharmacy service.

Science.gov (United States)

Stasiak, Philip; Afilalo, Marc; Castelino, Tanya; Xue, Xiaoqing; Colacone, Antoinette; Soucy, Nathalie; Dankoff, Jerrald

2014-05-01

Emergency departments (EDs) are recognized as a high-risk setting for prescription errors. Pharmacist involvement may be important in reviewing prescriptions to identify and correct errors. The objectives of this study were to describe the frequency and type of prescription errors detected by pharmacists in EDs, determine the proportion of errors that could be corrected, and identify factors associated with prescription errors. This prospective observational study was conducted in a tertiary care teaching ED on 25 consecutive weekdays. Pharmacists reviewed all documented prescriptions and flagged and corrected errors for patients in the ED. We collected information on patient demographics, details on prescription errors, and the pharmacists' recommendations. A total of 3,136 ED prescriptions were reviewed. The proportion of prescriptions in which a pharmacist identified an error was 3.2% (99 of 3,136; 95% confidence interval [CI] 2.5-3.8). The types of identified errors were wrong dose (28 of 99, 28.3%), incomplete prescription (27 of 99, 27.3%), wrong frequency (15 of 99, 15.2%), wrong drug (11 of 99, 11.1%), wrong route (1 of 99, 1.0%), and other (17 of 99, 17.2%). The pharmacy service intervened and corrected 78 (78 of 99, 78.8%) errors. Factors associated with prescription errors were patient age over 65 (odds ratio [OR] 2.34; 95% CI 1.32-4.13), prescriptions with more than one medication (OR 5.03; 95% CI 2.54-9.96), and those written by emergency medicine residents compared to attending emergency physicians (OR 2.21, 95% CI 1.18-4.14). Pharmacists in a tertiary ED are able to correct the majority of prescriptions in which they find errors. Errors are more likely to be identified in prescriptions written for older patients, those containing multiple medication orders, and those prescribed by emergency residents.

Origin and evolution of life on terrestrial planets.

Science.gov (United States)

Brack, A; Horneck, G; Cockell, C S; Bérces, A; Belisheva, N K; Eiroa, Carlos; Henning, Thomas; Herbst, Tom; Kaltenegger, Lisa; Léger, Alain; Liseau, Réne; Lammer, Helmut; Selsis, Franck; Beichman, Charles; Danchi, William; Fridlund, Malcolm; Lunine, Jonathan; Paresce, Francesco; Penny, Alan; Quirrenbach, Andreas; Röttgering, Huub; Schneider, Jean; Stam, Daphne; Tinetti, Giovanna; White, Glenn J

2010-01-01

The ultimate goal of terrestrial planet-finding missions is not only to discover terrestrial exoplanets inside the habitable zone (HZ) of their host stars but also to address the major question as to whether life may have evolved on a habitable Earth-like exoplanet outside our Solar System. We note that the chemical evolution that finally led to the origin of life on Earth must be studied if we hope to understand the principles of how life might evolve on other terrestrial planets in the Universe. This is not just an anthropocentric point of view: the basic ingredients of terrestrial life, that is, reduced carbon-based molecules and liquid H(2)O, have very specific properties. We discuss the origin of life from the chemical evolution of its precursors to the earliest life-forms and the biological implications of the stellar radiation and energetic particle environments. Likewise, the study of the biological evolution that has generated the various life-forms on Earth provides clues toward the understanding of the interconnectedness of life with its environment.

Drug interactions between common illicit drugs and prescription therapies.

Science.gov (United States)

Lindsey, Wesley T; Stewart, David; Childress, Darrell

2012-07-01

The aim was to summarize the clinical literature on interactions between common illicit drugs and prescription therapies. Medline, Iowa Drug Information Service, International Pharmaceutical Abstracts, EBSCO Academic Search Premier, and Google Scholar were searched from date of origin of database to March 2011. Search terms were cocaine, marijuana, cannabis, methamphetamine, amphetamine, ecstasy, N-methyl-3,4-methylenedioxymethamphetamine, methylenedioxymethamphetamine, heroin, gamma-hydroxybutyrate, sodium oxybate, and combined with interactions, drug interactions, and drug-drug interactions. This review focuses on established clinical evidence. All applicable full-text English language articles and abstracts found were evaluated and included in the review as appropriate. The interactions of illicit drugs with prescription therapies have the ability to potentiate or attenuate the effects of both the illicit agent and/or the prescription therapeutic agent, which can lead to toxic effects or a reduction in the prescription agent's therapeutic activity. Most texts and databases focus on theoretical or probable interactions due to the kinetic properties of the drugs and do not fully explore the pharmacodynamic and clinical implications of these interactions. Clinical trials with coadministration of illicit drugs and prescription drugs are discussed along with case reports that demonstrate a potential interaction between agents. The illicit drugs discussed are cocaine, marijuana, amphetamines, methylenedioxymethamphetamine, heroin, and sodium oxybate. Although the use of illicit drugs is widespread, there are little experimental or clinical data regarding the effects of these agents on common prescription therapies. Potential drug interactions between illicit drugs and prescription drugs are described and evaluated on the Drug Interaction Probability Scale by Horn and Hansten.

Precambrian supercontinents, glaciations, atmospheric oxygenation, metazoan evolution and an impact that may have changed the second half of Earth history

Directory of Open Access Journals (Sweden)

Grant M. Young

2013-05-01

Full Text Available In more than 4 Ga of geological evolution, the Earth has twice gone through extreme climatic perturbations, when extensive glaciations occurred, together with alternating warm periods which were accompanied by atmospheric oxygenation. The younger of these two episodes of climatic oscillation preceded the Cambrian “explosion” of metazoan life forms, but similar extreme climatic conditions existed between about 2.4 and 2.2 Ga. Over long time periods, changing solar luminosity and mantle temperatures have played important roles in regulating Earth's climate but both periods of climatic upheaval are associated with supercontinents. Enhanced weathering on the orogenically and thermally buoyed supercontinents would have stripped CO2 from the atmosphere, initiating a cooling trend that resulted in continental glaciation. Ice cover prevented weathering so that CO2 built up once more, causing collapse of the ice sheets and ushering in a warm climatic episode. This negative feedback loop provides a plausible explanation for multiple glaciations of the Early and Late Proterozoic, and their intimate association with sedimentary rocks formed in warm climates. Between each glacial cycle nutrients were flushed into world oceans, stimulating photosynthetic activity and causing oxygenation of the atmosphere. Accommodation for many ancient glacial deposits was provided by rifting but escape from the climatic cycle was predicated on break-up of the supercontinent, when flooded continental margins had a moderating influence on weathering. The geochemistry of Neoproterozoic cap carbonates carries a strong hydrothermal signal, suggesting that they precipitated from deep sea waters, overturned and spilled onto continental shelves at the termination of glaciations. Paleoproterozoic (Huronian carbonates of the Espanola Formation were probably formed as a result of ponding and evaporation in a hydrothermally influenced, restricted rift setting. Why did metazoan

Rotation of a Moonless Earth

Science.gov (United States)

Lissauer, Jack J.; Barnes, Jason W.; Chambers, John E.

2013-01-01

We numerically explore the obliquity (axial tilt) variations of a hypothetical moonless Earth. Previous work has shown that the Earth's Moon stabilizes Earth's obliquity such that it remains within a narrow range, between 22.1 deg and 24.5 deg. Without lunar influence, a frequency-map analysis by Laskar et al. showed that the obliquity could vary between 0 deg. and 85 deg. This has left an impression in the astrobiology community that a large moon is necessary to maintain a habitable climate on an Earth-like planet. Using a modified version of the orbital integrator mercury, we calculate the obliquity evolution for moonless Earths with various initial conditions for up to 4 Gyr. We find that while obliquity varies significantly more than that of the actual Earth over 100,000 year timescales, the obliquity remains within a constrained range, typically 20-25 deg. in extent, for timescales of hundreds of millions of years. None of our Solar System integrations in which planetary orbits behave in a typical manner show obliquity accessing more than 65% of the full range allowed by frequency-map analysis. The obliquities of moonless Earths that rotate in the retrograde direction are more stable than those of pro-grade rotators. The total obliquity range explored for moonless Earths with rotation periods shorter than 12 h is much less than that for slower-rotating moonless Earths. A large moon thus does not seem to be needed to stabilize the obliquity of an Earth-like planet on timescales relevant to the development of advanced life.

CHEMICAL EVOLUTION

Energy Technology Data Exchange (ETDEWEB)

Calvin, Melvin

1965-06-01

How did life come to be on the surface of the earth? Darwin himself recognized that his basic idea of evolution by variation and natural selection must be a continuous process extending backward in time through that period in which the first living things arose and into the period of 'Chemical Evolution' which preceded it. We are approaching the examination of these events by two routes. One is to seek for evidence in the ancient rocks of the earth which were laid down prior to that time in which organisms capable of leaving their skeletons in the rocks to be fossilized were in existence. This period is sometime prior to approximately 600 million years ago. The earth is believed to have taken its present form approximately 4700 million years ago. We have found in rocks whose age is about 1000 million years certain organic molecules which are closely related to the green pigment of plants, chlorophyll. This seems to establish that green plants were already fluorishing prior to that time. We have now found in rocks of still greater age, namely, 2500 million years, the same kinds of molecules mentioned above which can be attributed to the presence of living organisms. If these molecules are as old as the rocks, we have thus shortened the time available for the generation of the complex biosynthetic sequences which give rise to these specific hydrocarbons (polyisoprenoids) to less than 2000 million years.

42 CFR 423.159 - Electronic prescription drug program.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Electronic prescription drug program. 423.159 Section 423.159 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT Cost Control and Quality...

76 FR 59898 - Branded Prescription Drug Fee; Correction

Science.gov (United States)

2011-09-28

... Branded Prescription Drug Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION... Register on Thursday, August 18, 2011. The proposed regulation provides guidance relating to the branded... as follows: 1. On Page 51311, column 2, under the part heading PART 51--BRANDED PRESCRIPTION DRUGS...

Prescription for herbal healing

National Research Council Canada - National Science Library

Balch, Phyllis A; Bell, Stacey J

2012-01-01

.... From the most trusted name in natural healing, Phyllis A. Balch's new edition of Prescription for Herbal Healing provides the most current research and comprehensive facts in an easy-to-read A- to-Z format, including...

A model of the prescription-pharmaceutical sales process

Directory of Open Access Journals (Sweden)

Michael Stros

2018-06-01

Full Text Available The purpose of this paper is to determine the factors in marketing most relevant to achieving pharmaceutical sales success and their interrelations, as well as providing a prescription-pharmaceuticals sales process model. This will enable scholars to obtain a better understanding of the marketing process for prescription pharmaceuticals, as well as enabling marketers to apply more efficient marketing approaches. The study uses a unique data set, combining primary data and secondary data from the Swiss prescription-pharmaceuticals market. The data is analysed using a multiple-regression based model. A multi-level data structure is found, suggesting that factors concerning the specific brand and also the pharmaceutical substance itself are relevant to sales success. It is revealed that the factors most relevant to sales success are: order of market entry, perceived product-quality, average price, and marketing expenditures, leading to practical recommendations for scholars and marketing professionals. The study focuses only on the Swiss prescription-pharmaceuticals market, investigating five medical drug classes. The assumption is made that these results can be generalised to similar markets and drug classes. The study develops a conceptual prescription-pharmaceuticals sales-process model; offers practical guidelines and a good basis for further scholarly research are provided; and identifies several research gaps by giving proposals for future research.

Off-label prescriptions in diabetic foot

Directory of Open Access Journals (Sweden)

Luís Jesuíno de Oliveira Andrade

2014-09-01

Full Text Available Prescription of a drug outside of the indications for which it was originally approved by regulators is internationally known as "off-label" prescription. We describe off-label treatments for the diabetic foot reported in international scientific literature. This is a qualitative and descriptive bibliographical review based on the results of a search of the Medline international database. The criteria for review were publication between January 1985 and November 2013, and the MeSH (Medical Subject Heading keywords "off-label use" OR "off-label" OR "off-label prescribing" plus "diabetic foot" were input on the search form. Nine studies were selected that contained information about off-label treatments for the diabetic foot. We conclude that the practice of off-label prescribing has potential benefits. In some situations an off-label prescription is the only treatment available for patients, either because a more targeted drug does not exist, or because other methods of treatment are ineffective or unavailable due to patient intolerance.

Income and the use of prescription drugs for near retirement individuals

DEFF Research Database (Denmark)

Leth-Petersen, Søren; Skipper, Niels

Understanding how demand for prescription drugs responds to changes in income is important for assessing the welfare consequences of reforms affecting income. This becomes more imminent as age progresses, because the use of prescription drugs and the associated budgetary burden increases dramatic......Understanding how demand for prescription drugs responds to changes in income is important for assessing the welfare consequences of reforms affecting income. This becomes more imminent as age progresses, because the use of prescription drugs and the associated budgetary burden increases...... dramatically from about age 55. In this paper we estimate how demand for prescription drugs varies with income for a sample of near retirement individuals. Estimating the prescription drug demand response to income changes is complicated because an important explanatory variable, the health capital......, is unobserved, and because demand is potentially dynamic, for example because some drugs are habitual. The analysis is based on a novel panel data set with information about purchase of prescription drug demand for a very large number of Danish individuals over the period 1995-2003. Our preferred model...

Direct-to-consumer prescription drug advertising: history, regulation, and issues.

Science.gov (United States)

Huh, Jisu; DeLorme, Denise E; Reid, Leonard N; An, Soontae

2010-03-01

Direct-to-consumer advertising has changed the way prescription drugs are marketed in the United States. This article traces the history of direct-to-consumer advertising of prescription and over-the-counter medications and describes how drug advertising is regulated and by whom. It also discusses the controversies that surround direct-to-consumer marketing of prescription drugs.

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

Science.gov (United States)

McCabe, Sean Esteban; Boyd, Carol J.

2012-01-01

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

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

Science.gov (United States)

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

2013-05-01

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

Heroin and methadone prescriptions from a London drug clinic over the first 15 years of operation (1968-1983): old records examined.

Science.gov (United States)

Strang, John; Sheridan, Janie

2006-01-01

means of 20 to 40 mg and 25 to 50 mg daily for the injectable methadone ampules and the oral methadone solution, respectively. Major changes occurred in the prescribing practices of this London drug clinic over the first 15 years of operation of the new NHS clinics. However, these changes did not occur overnight and can be seen to have been gradual evolutions of practice with the preservation of heroin prescription through the first 5 years and the subsequent move to increased prescribing of injectable methadone, with both these practices being overtaken by the subsequent increased prominence of oral methadone syrup as the main drug prescribed. Reference to the original records reveals a more interesting picture than might be evident from the potentially selective recall of contemporary or historical commentators.

77 FR 46653 - Branded Prescription Drug Fee; Hearing

Science.gov (United States)

2012-08-06

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [REG-112805-10] RIN 1545-BJ39 Branded Prescription Drug Fee; Hearing AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice of... document provides notice of public hearing on proposed regulations relating to the branded prescription...

Prosthetic prescription in the Netherlands : an observational study

NARCIS (Netherlands)

van der Linde, H; Geertzen, JHB; Hofstad, CJ; Postema, K; Van Limbeek, Jacques

2003-01-01

Prosthetic prescription for lower limb amputees and the methodology used are primarily based on empirical knowledge. Clinical expertise plays an important role that can lead to an adequate prescription; however, a clear evidence based motivation for the choices made cannot be given. This can lead to

Prescription, dispensation and marketing patterns of methylphenidate

Directory of Open Access Journals (Sweden)

Edson Perini

2014-12-01

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

Prescription medicine sharing experience among pharmacy students

OpenAIRE

Šliogerytė, Karolina

2017-01-01

K.Šliogeryte`s master thesis. Master thesis supervisor associate professor Jonas Grincevičius (2015/2016), lecturer J. Daukšienė(2016/2017); Lithuanian University of Health Sciences, Faculty of Pharmacy, Pharmaceutical technology and Social pharmacy department. – Kaunas. Master thesis: prescription medicine sharing experience among pharmacy students. The aim: to evaluate LUHS Pharmacy faculty students` experience in prescription drugs` sharing. Methods: empirical qualitative method...

Thermal structure of the accreting earth

International Nuclear Information System (INIS)

Turcotte, D.L.; Pflugrath, J.C.

1985-01-01

The energy associated with the accretion of the earth and the segregation of the core is more than sufficient to melt the entire earth. In order to understand the thermal evolution of the early earth it is necessary to study the relevant heat transfer mechanisms. In this paper we postulate the existence of a global magma ocean and carry out calculations of the heat flux through it in order to determine its depth. In the solid mantle heat is transferred by the upward migration of magma. This magma supplies the magma ocean. The increase in the mantle liquidus with depth (pressure) is the dominant effect influencing heat transfer through the magma ocean. We find that a magma ocean with a depth of the order of 20 km would have existed as the earth accreted. We conclude that the core segregated and an atmosphere was formed during accretion

Solar Radiation as Driving Force In Early Evolution

Science.gov (United States)

Rothschild, Lynn J.; Peterson, David L. (Technical Monitor)

2002-01-01

Ultraviolet radiation (UVR) has provided an evolutionary challenge to life on Earth in that it is both an agent of mutation and as well as a selective force. Today surface fluxes of UVR vary diurnally, seasonally, etc. Still, the UVR flux was probably substantially higher during the early phases of evolution, suggesting that its role in evolution was even more prominent during this time. In this presentation, the creative role of UVR in evolution is discussed, specifically in connection with the role that UVR may have played in the evolution of early microbial ecosystems. The presentation will include discussions of the direct influence of UVR on such processes as photosynthesis and genetic damage, as well as the indirect influence of UVR as mediated through the production of reactive oxygen species. These biological effects of UVR will be viewed against the backdrop of the physical nature of the early Earth, surely a very different place then than now.

21 CFR 1306.13 - Partial filling of prescriptions.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Partial filling of prescriptions. 1306.13 Section 1306.13 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS Controlled... by revising paragraph (a), effective June 1, 2010. For the convenience of the user, the revised text...

77 FR 48111 - Branded Prescription Drug Fee; Correction

Science.gov (United States)

2012-08-13

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [REG-112805-10] RIN 1545-BJ39 Branded Prescription Drug Fee; Correction AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Notice..., August 6, 2012 (77 FR 46653) relating to the branded prescription drug fee imposed by the Affordable Care...

INTERACTION OF CLOSE-IN PLANETS WITH THE MAGNETOSPHERE OF THEIR HOST STARS. II. SUPER-EARTHS AS UNIPOLAR INDUCTORS AND THEIR ORBITAL EVOLUTION

International Nuclear Information System (INIS)

Laine, Randy O.; Lin, Douglas N. C.

2012-01-01

Planets with several Earth masses and orbital periods of a few days have been discovered through radial velocity and transit surveys. Regardless of their formation mechanism, an important evolution issue is the efficiency of their retention in the proximity of their host stars. If these 'super-Earths' attained their present-day orbits during or shortly after the T Tauri phase of their host stars, a large fraction of these planets would have encountered an intense stellar magnetic field. These rocky planets have a higher conductivity than the atmosphere of their host stars and, therefore, the magnetic flux tube connecting them would slip though the envelope of the host stars faster than across the planets. The induced electromotive force across the planet's diameter leads to a potential drop which propagates along a flux tube away from the planet with an Alfvén speed. The foot of the flux tube would sweep across the stellar surface and the potential drop across the field lines drives a DC current analogous to that proposed for the electrodynamics of the Io-Jupiter system. The ohmic dissipation of this current produces potentially observable hot spots in the star envelope. It also heats the planet and leads to a torque which drives the planet's orbit to evolve toward both circularization and a state of synchronization with the spin of the star. The net effect is the damping of the planet's orbital eccentricity. Around slowly (or rapidly) spinning stars, this process also causes rocky planets with periods less than a few days to undergo orbital decay (or expansion/stagnation) within a few Myr. In principle, this effect can determine the retention efficiency of short-period hot Earths. We also estimate the ohmic dissipation interior to these planets and show that it can lead to severe structure evolution and potential loss of volatile material in them. However, these effects may be significantly weakened by the reconnection of the induced field.

Getting a prescription filled

Science.gov (United States)

... get a prescription from your provider, you may buy the medicine in different ways. LOCAL PHARMACIES The most common ... long-term medicines you use for chronic problems. Buy short-term medicines and drugs that need to be stored at ...

The influence of prescription monitoring programs on chronic pain management.

Science.gov (United States)

Wang, Jing; Christo, Paul J

2009-01-01

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

Impact of the Hydrocodone Schedule Change on Opioid Prescription Patterns in South Dakota.

Science.gov (United States)

Kuschel, Lauren M; Mort, Jane M

2017-10-01

Prescription opioid use is becoming increasingly common; consequently, opioid overdose deaths are increasing at an alarming rate. Hydrocodone, one of the most commonly abused opioids, was changed from a schedule III controlled substance to the more stringent schedule II to decrease abuse and diversion, effective Oct. 6, 2014. The objective of this study was to examine the impact of the hydrocodone schedule change on opioid prescribing in South Dakota. Opioid prescription patterns were examined in the following six-month phases: the baseline phase before the change, the transition phase when existing hydrocodone prescriptions could still be refilled, and the final phase. The South Dakota Board of Pharmacy Prescription Drug Monitoring Program provided aggregate monthly data for South Dakota opioid prescriptions (i.e., total number of prescriptions and days supplied), including urban and rural stratification. T-tests were performed on the monthly values for each phase to determine the significance of differences in prescription features between phases. The number of hydrocodone prescriptions significantly decreased 14 percent from baseline to final phase, while the days supplied per prescription significantly increased 7.4 percent. These changes were greater in rural areas than in urban areas. Conversely, the number of other opioid prescriptions significantly increased by 6.5 percent over this timeframe. The number of hydrocodone prescriptions decreased, while the days supplied per prescription increased. These changes were greater in rural areas than in urban areas. In addition, the number of other opioid prescriptions increased. These trends may reflect some unintended effects of the schedule change.

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

Science.gov (United States)

Frost, Timothy P; Adams, Alex J

2017-11-01

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

Differences in prevalence of prescription opiate misuse among rural and urban probationers.

Science.gov (United States)

Havens, Jennifer R; Oser, Carrie B; Leukefeld, Carl G; Webster, J Matthew; Martin, Steven S; O'Connell, Daniel J; Surratt, Hilary L; Inciardi, James A

2007-01-01

We compared the prevalence of prescription opiate misuse among 2 cohorts of felony probationers (N = 1525). Multiple logistic regression was utilized to determine the independent correlates of prescription opiate misuse among rural (n = 782) and urban (n = 743) probationers participating in an HIV-intervention study. After adjustment for differences in demographic and drug use characteristics, rural participants were almost five times more likely than their urban counterparts to have misused prescription opiates. The prevalence of prescription opiate misuse was significantly higher among the rural probationers; however, given the paucity of illicit opiates and relatively recent emergence of prescription opiates in rural areas, rural substance abuse treatment may be ill-prepared to treat prescription opiate misuse.

Study on drug costs associated with COPD prescription medicine in Denmark

DEFF Research Database (Denmark)

Jakobsen, M; Anker, N; Dollerup, J

2013-01-01

that the costs associated with COPD in Denmark are significant, but costs of prescription medicine for COPD were not analysed. OBJECTIVES: To analyse the societal costs associated with prescription medicine for COPD in Denmark. METHODS: The study was designed as a nationwide retrospective register study...... in 2010 with total costs of DKK 685 million (EUR 92 million). The average lifetime costs associated with COPD prescription medicine were estimated to be DKK 70,000-75,000 (EUR 9,416-10,089) per patient (2010 prices). CONCLUSION: The costs associated with prescription medicine for COPD in Denmark...... of the drug costs (ATC group R03) associated with COPD in the period 2001-2010. Data were retrieved from the Prescription Database, the National Patient Register and the Centralised Civil Register. The population comprised individuals (40+ years) who had at least one prescription of selected R03 drugs and who...

STUDY ON DRUG COSTS ASSOCIATED WITH COPD PRESCRIPTION MEDICINE IN DENMARK

DEFF Research Database (Denmark)

Jakobsen, Iris Marie; Anker, Niels; Dolleru, Jens

2012-01-01

that the costs associated with COPD in Denmark are significant, but costs of prescription medicine for COPD were not analysed. OBJECTIVES: To analyse the societal costs associated with prescription medicine for COPD in Denmark. METHODS: The study was designed as a nationwide retrospective register study...... in 2010 with total costs of DKK 685 million (EUR 92 million). The average lifetime costs associated with COPD prescription medicine were estimated to be DKK 70,000-75,000 (EUR 9,416-10,089) per patient (2010 prices). CONCLUSION: The costs associated with prescription medicine for COPD in Denmark...... of the drug costs (ATC group R03) associated with COPD in the period 2001-2010. Data were retrieved from the Prescription Database, the National Patient Register and the Centralised Civil Register. The population comprised individuals (40+ years) who had at least one prescription of selected R03 drugs and who...

Symmetry and topology in evolution

International Nuclear Information System (INIS)

Lukacs, B.; Berczi, S.; Molnar, I.; Paal, G.

1991-10-01

This volume contains papers of an interdisciplinary symposium on evolution. The aim of this symposium, held in Budapest, Hungary, 28-29 May 1991, was to clear the role of symmetry and topology at different levels of the evolutionary processes. 21 papers were presented, their topics included evolution of the Universe, symmetry of elementary particles, asymmetry of the Earth, symmetry and asymmetry of biomolecules, symmetry and topology of lining objects, human asymmetry etc. (R.P.)

Impact of legislation and a prescription monitoring program on the prevalence of potentially inappropriate prescriptions for monitored drugs in Ontario: a time series analysis

Science.gov (United States)

Juurlink, David; Yao, Zhan; Camacho, Ximena; Paterson, J. Michael; Singh, Samantha; Dhalla, Irfan; Sproule, Beth; Mamdani, Muhammad

2014-01-01

Background The increased use of opioid analgesics, sedative hypnotics and stimulants, coupled with the associated risks of overdose have raised concerns around the inappropriate prescribing of these monitored drugs. We assessed the impact of new legislation, the Narcotics Safety and Awareness Act, and a centralized Narcotics Monitoring System (implemented November 2011 and May 2012, respectively), on the dispensing of prescriptions suggestive of misuse. Methods We conducted a time series analysis of publicly funded prescriptions for opioids, benzodiazepines and stimulants dispensed monthly in Ontario from January 2007 to May 2013, based on information in the Ontario Public Drug Benefit Database. In the primary analysis, a prescription was deemed potentially inappropriate if it was dispensed within 7 days of an earlier prescription and was for at least 30 tablets of a drug in the same class as the earlier prescription, but originated from a different physician and a different pharmacy. Results After enactment of the new legislation, the prevalence of potentially inappropriate opioid prescriptions decreased by 12.5% in 6 months (from 1.6% in October 2011 to 1.4% in April 2012; p = 0.01). No further significant change was observed after the introduction of the narcotic monitoring system (p = 0.8). By May 2013, the prevalence had dropped to 1.0%. Inappropriate benzodiazepine prescribing was significantly influenced by both the legislation (p significantly influenced by the introduction of the monitoring system in May 2012, falling from 0.7% in April 2012 to 0.3% in May 2013 (p = 0.02). Interpretation For a select group of drugs prone to misuse and diversion, legislation and a prescription monitoring program reduced the prevalence of prescriptions suggestive of misuse. This suggests that regulatory interventions can promote appropriate prescribing which could potentially be applied to other jurisdictions and drugs of concern. PMID:25485251

Nonmedical Prescription Drug Use among Midwestern Rural Adolescents

Science.gov (United States)

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

2016-01-01

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

76 FR 59897 - Branded Prescription Drug Fee; Correction

Science.gov (United States)

2011-09-28

... DEPARTMENT OF THE TREASURY Internal Revenue Service 26 CFR Part 51 [TD 9544] RIN 1545-BK34 Branded... branded prescription drugs. This fee was enacted by section 9008 of the Patient Protection and Affordable...: This correction is effective on September 28, 2011 and applies to any fee on branded prescription drug...

Solar Photoelectrochemical Energy Conversion using Earth-Abundant Nanomaterials

Science.gov (United States)

Lukowski, Mark A.

Although the vast majority of energy consumed worldwide is derived from fossil fuels, the growing interest in making cleaner alternative energies more economically viable has motivated recent research efforts aimed to improve photovoltaic, wind, and biomass power generation. Clean power generation also requires clean burning fuels, such as H2 and O2, so that energy can still be provided on demand at all times, despite the intermittent nature inherent to solar or wind power. My research has focused on the rational approach to synthesizing earth-abundant nanomaterials with applications in the generation of clean alternative fuels and understanding the structure-property relationships which directly influence their performance. Herein, we describe the development of low-cost, earth-abundant layered metal chalcogenides as high-performance electrocatalysts for hydrogen evolution, and hematite photoanodes for photoelectrochemical oxygen evolution. This work has revealed a particularly interesting concept where catalytic performance can be enhanced by controlling the phase behavior of the material and taking advantage of previously unexploited properties to overcome the challenges traditionally limiting the performance of these layered materials for hydrogen evolution catalysis.

Empiric antibiotic prescription among febrile under-five Children in ...

African Journals Online (AJOL)

limiting viral infection and therefore, would not require antibiotics. Over prescription of antibiotics increases antibiotics exposure and development of resistance among patients. There is need to evaluate empiric antibiotic prescription in order to limit ...

Two Years of ePrescription in Slovenia - Applications and Potentials.

Science.gov (United States)

Stanimirovic, Dalibor; Savic, Dusan

2018-01-01

ePrescription is one of the most successful eHealth solutions in Slovenia. Since its national roll-out in early 2016, the quality of its operations has been constantly improving, and the number of users has been growing ever since to reach today's 90% of all healthcare providers. ePrescription facilitates more transparent and safer prescribing of medications, an overview of possible medication interactions, and reduction of administrative and opportunity costs. This paper initially explores the current state of ePrescription in Slovenia and different aspects of its application. Based on the research findings, the paper finally outlines potentials of ePrescription, which could be transformed into tangible benefits with particular implications for healthcare system. The research is based on focus group methodology. Structured discussions were conducted with eminent experts currently in charge of ePrescription (and other eHealth solutions) development and implementation in Slovenia. Research results imply that certain application aspects are relatively easy to define and evaluate, while the overall potentials of ePrescription are difficult to determine in many cases, and relatively unexplored in terms of their implications and operational feasibility.

Atmospheric evolution on inhabited and lifeless worlds

CERN Document Server

Catling, David C

2017-01-01

As the search for Earth-like exoplanets gathers pace, in order to understand them, we need comprehensive theories for how planetary atmospheres form and evolve. Written by two well-known planetary scientists, this text explains the physical and chemical principles of atmospheric evolution and planetary atmospheres, in the context of how atmospheric composition and climate determine a planet's habitability. The authors survey our current understanding of the atmospheric evolution and climate on Earth, on other rocky planets within our Solar System, and on planets far beyond. Incorporating a rigorous mathematical treatment, they cover the concepts and equations governing a range of topics, including atmospheric chemistry, thermodynamics, radiative transfer, and atmospheric dynamics, and provide an integrated view of planetary atmospheres and their evolution. This interdisciplinary text is an invaluable one-stop resource for graduate-level students and researchers working across the fields of atmospheric science...

An inevitable wave of prescription drug monitoring programs in the context of prescription opioids: pros, cons and tensions.

Science.gov (United States)

Islam, M Mofizul; McRae, Ian S

2014-08-16

In an effort to control non-medical use and/or medical abuse of prescription drugs, particularly prescription opioids, electronic prescription drug monitoring programs (PDMP) have been introduced in North-American countries, Australia and some parts of Europe. Paradoxically, there are simultaneous pressures to increase opioid prescribing for the benefit of individual patients and to reduce it for the sake of public health, and this pressure warrants a delicate balance of appropriate therapeutic uses of these drugs with the risk of developing dependence. This article discusses pros and cons of PDMP in reducing diversion of prescription opioids, without hampering access to those medications for those with genuine needs, and highlights tensions around PDMP implementation. PDMPs may help alleviate diversion, over-prescription and fraudulent prescribing/dispensing; prompt drug treatment referrals; avoid awkward drug urine test; and inform spatial changes in prescribing practices and help designing tailored interventions. Fear of legal retribution, privacy and data security, potential confusion about addiction and pseudo-addiction, and potential undue pressure of detecting misuse/diversion - are the major problems. There are tensions about unintended consequence of excessive regulatory enforcements, corresponding collateral damages particularly about inadequate prescribing for patients with genuine needs, and mandatory consultation requirements of PDMP. In this era of information technology PDMP is likely to flourish and remain with us for a long time. A clear standard of practice against which physicians' care will be judged may expedite the utilisation of PDMP. In addition, adequate training on addiction and pain management along with public awareness, point-of-supply data entry from pharmacy, point-of-care real-time access to data, increasing access to addiction treatment and appropriate regulatory enforcement preferably through healthcare administration, together

The size distribution of the earth-approaching asteroids

Science.gov (United States)

Rabinowitz, D. L.

1993-01-01

The discovery circumstances of the first asteroids ever observed outside the earth's atmosphere but within the neighborhood of the earth-moon system are described. Four natural objects with diameters in the range 5-50 m were detected during a search for earth-approaching asteroids conducted each month at the 0.91-m Spacewatch Telescope at Kitt Peak. An additional 19 earth approachers with sizes in the range 50 m to 5 km were discovered. These obervations determine the cumulative flux of asteroids near earth as a function of absolute magnitude. For asteroids larger than about 100 m, a power-law dependence with exponent of about 0.9 is observed, consistent with their evolution from the main-belt population. At about 10 m, the flux is more than two orders of magnitude greater than this power-law extrapolation.

Delivery of information from earth observation satellites

International Nuclear Information System (INIS)

MacDonald, J.S.

1992-01-01

Satellite-based systems for measuring the surface of the earth and its atmosphere from space have evolved rapidly in the past decade. The amount of data available in the future promises to be truly staggering. This paper addresses the requirements for handling data from earth observation systems. It begins with the premise that our objective is to acquire an understanding of the state and evolution of our planet, and proceeds from there to argue that earth observation satellite systems are, in reality, systems for delivering information. This view has implications on how we approach the design of such systems, and how we handle the data they produce in order to derive maximum benefit from them. The paper examines these issues and puts forth some of the technical requirements for future satellite-based earth observation systems, based on the concept that earth observation is a quantitative measurement discipline that is driven by requirements for information. (Author). 8 refs., 3 figs

The Prescription Drug Marketing Act of 1987.

Science.gov (United States)

Greenberg, R B

1988-10-01

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

[Prescription drug abuse in elderly psychiatric patients].

Science.gov (United States)

Wetterling, Tilman; Schneider, Barbara

2012-08-01

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

The Impact of Modeling Assumptions in Galactic Chemical Evolution Models

Science.gov (United States)

Côté, Benoit; O'Shea, Brian W.; Ritter, Christian; Herwig, Falk; Venn, Kim A.

2017-02-01

We use the OMEGA galactic chemical evolution code to investigate how the assumptions used for the treatment of galactic inflows and outflows impact numerical predictions. The goal is to determine how our capacity to reproduce the chemical evolution trends of a galaxy is affected by the choice of implementation used to include those physical processes. In pursuit of this goal, we experiment with three different prescriptions for galactic inflows and outflows and use OMEGA within a Markov Chain Monte Carlo code to recover the set of input parameters that best reproduces the chemical evolution of nine elements in the dwarf spheroidal galaxy Sculptor. This provides a consistent framework for comparing the best-fit solutions generated by our different models. Despite their different degrees of intended physical realism, we found that all three prescriptions can reproduce in an almost identical way the stellar abundance trends observed in Sculptor. This result supports the similar conclusions originally claimed by Romano & Starkenburg for Sculptor. While the three models have the same capacity to fit the data, the best values recovered for the parameters controlling the number of SNe Ia and the strength of galactic outflows, are substantially different and in fact mutually exclusive from one model to another. For the purpose of understanding how a galaxy evolves, we conclude that only reproducing the evolution of a limited number of elements is insufficient and can lead to misleading conclusions. More elements or additional constraints such as the Galaxy’s star-formation efficiency and the gas fraction are needed in order to break the degeneracy between the different modeling assumptions. Our results show that the successes and failures of chemical evolution models are predominantly driven by the input stellar yields, rather than by the complexity of the Galaxy model itself. Simple models such as OMEGA are therefore sufficient to test and validate stellar yields. OMEGA

Psychotropic medicine prescriptions in Italian youths: a multiregional study.

Science.gov (United States)

Piovani, Daniele; Clavenna, Antonio; Cartabia, Massimo; Bonati, Maurizio

2016-03-01

The aim of the study was to evaluate the trend of paediatric psychotropic drug prescriptions in Italy. Data sources were regional, outpatient prescription databases. Seven Italian regions, covering 50 % of the Italian population, provided data from 2006 to 2011. Prevalence and incidence of prescriptions by age and gender were evaluated for psychotropic, antidepressant, antipsychotic, and attention-deficit/hyperactivity disorders (ADHD) medications. The hospital admission rate for psychiatric conditions was calculated, also at the local health unit (LHU) level. The presence of trends in prescription prevalence and incidence during the 6 year period was assessed. Finally, the correlation between prevalence, prescription, hospital admission rates, latitude, longitude, and average annual income at the LHU level was also investigated. In 2011, 8834 youths received at least one psychotropic drug prescription, with a prevalence of 1.76 ‰ (95 % CI 1.72-1.80). The incidence of new psychotropic drug users was 1.03 ‰ (1.00-1.06). The prevalence of antidepressants was 1.02 ‰ (0.99-1.04), while that of antipsychotics was 0.70 ‰ (0.68-0.72), and that of ADHD medications 0.19 ‰ (0.18-0.21). The psychotropic drug prevalence increased with increasing age. Males were more exposed to psychotropic drugs than females (AUC0-17 male/female = 1.23). Antipsychotics were the most prescribed psychotropic drugs in males, while antidepressants were in females. Between-region prevalence ranged from 1.56 to 2.17 ‰. The overall prevalence of psychotropic drug from 2006 to 2011 was stable (χ(t)2 ≤ 0.001, p = 0.97). No correlation was found between prevalence and the variables investigated. Psychotropic drug prescription was very limited and stable. No geographical patterns were found.

Association of childhood abuse and prescription opioid use in early adulthood.

Science.gov (United States)

Austin, Anna E; Shanahan, Meghan E; Zvara, Bharathi J

2018-01-01

Previous research has examined the association of childhood abuse with opioid misuse and dependence in adulthood. However, little research has focused specifically on prescription opioids, and no studies have examined associations with prescription opioid use, a potential pathway to later opioid misuse and dependence. The aim of the present study was to examine the association of childhood emotional, physical, and sexual abuse with prescription opioid use in early adulthood. We used data from Waves I (12-18years) and IV (24-32years) of the National Longitudinal Study of Adolescent to Adult Health. At Wave IV, respondents reported experiences of childhood abuse occurring prior to age 18years and prescription opioid use in the last four weeks. We conducted multivariable logistic regression to examine associations of childhood abuse with recent prescription opioid use. In multivariable models adjusted for respondent sex, race/ethnicity, age, and socioeconomic status, childhood emotional abuse (OR=1.57, 95% CI 1.29, 1.90), physical abuse (OR=1.46, 95% CI 1.14, 1.87), and any childhood abuse (OR=1.51, 95% CI 1.24, 1.82) were significantly associated with recent prescription opioid use. Given continued increases in prescription opioid use and opioid-related morbidity and mortality in the U.S., understanding upstream social and environmental factors associated with prescription opioid use is important to strengthening and expanding current prevention and intervention strategies. Future research is needed to examine factors potentially mediating the association between childhood abuse and prescription opioid use in order to provide additional insights for prevention and intervention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Moral hazard and prescription medicine use in Australia--the patient perspective.

Science.gov (United States)

Doran, Evan; Robertson, Jane; Henry, David

2005-04-01

All Australian citizens are provided affordable access to prescription medicines through the nation's system of universal pharmaceutical subsidies--the pharmaceutical benefits scheme. The rapid increase in pharmaceutical related expenditure has generated the concern that Australians are taking advantage of prescription subsidies and are using more medicines than are necessary, thereby creating a 'moral hazard'. This concern is predicated on a number of assumptions about patient behaviour rather than on empirical observation. These assumptions amount to a view that patients are consumers who treat prescription medicines as common goods subject to informed and rational calculation of the cost and benefits of their use. This paper reports the findings of an in-depth interview study undertaken to explore how prescription cost influences Australians' medicine use. Qualitative data were analysed to compare medicine users' descriptions of the role of prescription cost in medicine use against the assumptions that underlie the belief in moral hazard. Moral hazard did not appear to be significantly operating in the accounts of medicine use collected for this study. Interviewees' accounts of medicine use revealed an act characterised by ambivalence, a mix of desire and antipathy, faith and suspicion. Medicines appeared in interviewees' accounts as both pharmacologically and symbolically potent substances, which despite their familiarity as objects, are often mysterious to non-expert patients. Cost appeared as a secondary factor in patients' decision to access a prescription medicine. Using a prescription was predicated on the medicine being necessary, with necessity typically established by an expert doctor prescribing the medicine. Prescription medicines did not appear as 'common goods' where subsidised access motivates a 'consumer' to demand more or make the prospect of prescription use more attractive or necessary.

The application characteristics of Zhongjing external prescription medicine

Directory of Open Access Journals (Sweden)

Hui Zhao

2017-12-01

Full Text Available Objective: To explore the application characteristics of Zhongjing prescription topical Chinese medicine. Methods: in this paper, according to the dosage form, Zhongjing topical agent will be divided into suppository, smoked lotion, apply is scattered, plug nasal powder four categories. Through an analysis on its books, records, and clinical applications, we are able to sum up the application characteristics of the zhongjing agent for external use. Results: in the clinical medicine, topical Zhongjing prescription cure of the disease has a long history of the role, through the analysis of Zhongjing topical prescription whole thinking, dialectical thinking, and thinking and characteristics of treatment technology that has the characteristics of topical drugs, dosage form differentiation flexible, external treatment for internal diseases, both inside and outside. Conclusion: topical medicine not only in the clinical treatment effect is good, and to inherit and develop Zhang Zhongjing thought of medicine, medical practice, law, strengthen Zhong Jing prescription and medicine, to enrich TCM clinical diagnosis and treatment methods to improve the clinical efficacy of traditional Chinese medicine, Chinese medicine clinics provide high standards of service for patients.

Geographical and temporal variations in clozapine prescription for schizophrenia

DEFF Research Database (Denmark)

Nielsen, Jimmi; Røge, Rasmus; Schjerning, Ole

2012-01-01

Despite its unsurpassed efficacy in treatment-resistant schizophrenia, clozapine remains underutilized. Trends in the prescription of clozapine in patients with ICD-10 F20.x schizophrenia were assessed using data from Danish national registers. Three substudies were carried out: (i) an assessment...... of differences in national prescription patterns between 1996 and 2007 using a cross-sectional design; (ii) a comparison of time from first schizophrenia diagnosis to first prescription of clozapine in a five-year cohort study, using the Cox regression model, of two patient groups who were first diagnosed...

Antibiotic prescriptions for outpatient acute rhinosinusitis in Canada, 2007-2013

Science.gov (United States)

Weese, Scott; Glass-Kaastra, Shiona; McIsaac, Warren

2017-01-01

Introduction Acute rhinosinusitis (ARS) is a respiratory disease commonly caused by viral infections. Physicians regularly prescribe antibiotics despite bacterial etiologies being uncommon. This is of concern, as this use adds to the selection pressure for resistance. Here we present the descriptive epidemiology of acute rhinosinusitis and corresponding antibiotic prescribing practices by Canadian outpatient physicians from 2007–2013. Materials/Methods Diagnosis and antibiotic prescription data for ARS were extracted from the Canadian Disease and Therapeutic Index for 2007 to 2013, and population data were acquired from Statistics Canada. ARS diagnosis and antibiotic prescription rates and frequencies of antibiotic classes were calculated. Results Eighty-eight percent of patients diagnosed with ARS in 2013 were adults, with a greater rate of antibiotic prescriptions observed among the adults relative to the pediatric patients (1632.9 and 468.6 antibiotic prescriptions per 10,000 inhabitants). Between 2007 and 2013, the ARS diagnosis rate decreased from 596 to 464 diagnoses per 10,000 inhabitants, while the percentage of diagnoses with antibiotic prescriptions at the national level remained stable (87% to 84%). From 2007 to 2013, prescription rates for macrolides decreased from 203.5 to 105.4 prescriptions per 10,000 inhabitants. In 2013, penicillins with extended spectrum were more commonly prescribed compared to macrolides among adult patients (153.5 and 105.4 prescriptions per 10,000 inhabitants, respectively). Conclusion This study is the first to describe physician antibiotic prescribing practices for treatment of ARS in Canada. Results show that antibiotic treatment for ARS represents an area for implementing antimicrobial stewardship, and through it, managing antibiotic resistance. Further work is required to better understand diagnosing practices and treatment criteria for ARS, and use this information to further assist physicians to limit unnecessary

Limits in the evolution of biological form: a theoretical morphologic perspective.

Science.gov (United States)

McGhee, George R

2015-12-06

Limits in the evolution of biological form can be empirically demonstrated by using theoretical morphospace analyses, and actual analytic examples are given for univalved ammonoid shell form, bivalved brachiopod shell form and helical bryozoan colony form. Limits in the evolution of form in these animal groups can be shown to be due to functional and developmental constraints on possible evolutionary trajectories in morphospace. Future evolutionary-limit research is needed to analyse the possible existence of temporal constraint in the evolution of biological form on Earth, and in the search for the possible existence of functional alien life forms on Titan and Triton that are developmentally impossible for Earth life.

Understanding Adherence and Prescription Patterns Using Large-Scale Claims Data.

Science.gov (United States)

Bjarnadóttir, Margrét V; Malik, Sana; Onukwugha, Eberechukwu; Gooden, Tanisha; Plaisant, Catherine

2016-02-01

Advanced computing capabilities and novel visual analytics tools now allow us to move beyond the traditional cross-sectional summaries to analyze longitudinal prescription patterns and the impact of study design decisions. For example, design decisions regarding gaps and overlaps in prescription fill data are necessary for measuring adherence using prescription claims data. However, little is known regarding the impact of these decisions on measures of medication possession (e.g., medication possession ratio). The goal of the study was to demonstrate the use of visualization tools for pattern discovery, hypothesis generation, and study design. We utilized EventFlow, a novel discrete event sequence visualization software, to investigate patterns of prescription fills, including gaps and overlaps, utilizing large-scale healthcare claims data. The study analyzes data of individuals who had at least two prescriptions for one of five hypertension medication classes: ACE inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers, and diuretics. We focused on those members initiating therapy with diuretics (19.2%) who may have concurrently or subsequently take drugs in other classes as well. We identified longitudinal patterns in prescription fills for antihypertensive medications, investigated the implications of decisions regarding gap length and overlaps, and examined the impact on the average cost and adherence of the initial treatment episode. A total of 790,609 individuals are included in the study sample, 19.2% (N = 151,566) of whom started on diuretics first during the study period. The average age was 52.4 years and 53.1% of the population was female. When the allowable gap was zero, 34% of the population had continuous coverage and the average length of continuous coverage was 2 months. In contrast, when the allowable gap was 30 days, 69% of the population showed a single continuous prescription period with an average length of 5

Biological evolution: Some genetic considerations

OpenAIRE

Salem, Mohammad Saad Zaghloul

2014-01-01

Background: The concept of biological evolution has long been accepted as a palatable theory aiming at explaining how life began and how creatures diverged so widely along the life span of the earth. Meticulous analysis and criticism of the different postulations of this concept, however, reveals that evolution is an illogic concept based on theoretical hypotheses that can never be tested. Creation, on the other hand, represents the other side of the coin, and up till now debates confronting ...

Asthma prescription patterns for children: can GPs do better?

NARCIS (Netherlands)

Uijen, J.H.J.M.; Wouden, J.C. van der; Schellevis, F.G.; Willemsen, S.P.; Suijlekom-Smit, L.W.A. van; Bindels, P.J.E.

2011-01-01

Background: Assessing prescription patterns of asthma medication for children is helpful to optimize prescribing by general practitioners (GPs). The aim was to explore prescription patterns in children with physician-diagnosed asthma and its determinants in general practice. Methods: We used the

Use of a generic protocol in documentation of prescription errors in Estonia, Norway and Sweden

Directory of Open Access Journals (Sweden)

Haavik S

2012-06-01

Full Text Available Pharmacists have an important role in detecting, preventing, and solving prescription problems, which if left unresolved, may pose a risk of harming the patient.Objective: The objectives of this study were to evaluate the feasibility of a generic study instrument for documentation of prescription problems requiring contact with prescriber before dispensing. The study was organized: 1 by countries: Estonia, Norway and Sweden; 2 by type of prescriptions: handwritten prescriptions, printouts of prescriptions in the electronic medical record and electronically transmitted prescriptions to pharmacies; and 3 by recording method - self-completion by pharmacists and independent observers.Methods: Observational study with independent observers at community pharmacies in Estonia (n=4 and Sweden (n=7 and self-completed protocols in Norway (n=9.Results: Pharmacists’ in Estonia contacted the prescriber for 1.47% of the prescriptions, about 3 times as often as in Norway (0.45% and Sweden (0.38%. Handwritten prescriptions dominated among the problem prescriptions in Estonia (73.2%, printouts of prescriptions in the electronic medical record (89.1% in Norway and electronically transmitted prescriptions to pharmacies (55.9% in Sweden.More administrative errors were identified on handwritten prescriptions and printouts of prescriptions in the electronic medical record in Estonia and in Norway compared with electronically transmitted prescriptions to pharmacies in Sweden (p<0.05 for prescription types and p<0.01 for countries. However, clinically important errors and delivery problems appeared equally often on the different types of prescriptions. In all three countries, only few cases of drug interactions and adverse drug reactions were identified.Conclusion: Despite the different patterns of prescription problems in three countries, the instrument was feasible and can be regarded appropriate to document and classify prescription problems necessitating contact

PRESCRIPTION OF PHYSICAL EXERCISES FOR ELDERLY

Directory of Open Access Journals (Sweden)

Sheilla Tribess

2005-11-01

Full Text Available The present study has as objective investigates the prescription of exercises for elderly, constant in the literature in portuguese language, under form of books, newspapers, annals and publications electronics. For so much, it tried to collect data with relationship to the following aspects: a Impact of the aging in the human organism; b evaluation of the components of the functional aptitude; and, c composition of a program of physical exercise. The aging process evidences changes in the levels antropométrics, neuromuscular, cardiovascular, lung, neural, besides the decrease of the agility, coordination, balance, flexibility, mobility to articulate and increase in the cartilage rigidity, tendons and ligaments. Those changes associated to the low level of physical activity in the elderly take to the decline of the functional capacity. The evaluation of the level of functional dependence becomes important to the elderly, because it will provide a prescription of physical exercises more addressed your needs, increasing the effectiveness of the program and reducing the risks. The general beginnings for the prescription of physical exercises for elderly are based in the modalities appropriate, intensity, duration, frequency and progression of the physical activity, with the objective of improving the life quality, to minimize the physiologic alterations, to improve the motive capacity and to provide benefits social, psychological and physical. Therefore, in the prescription of physical exercises for older people is necessary the training of the capacity aerobics, of the force, of the balance, of the time of reaction and movement and of the agility.

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science; Volume 109; Issue 1 ... Crustal evolution; granites; Phanerozoic; Sr-Nd isotopes; east-central Asia. ... Department of Geology, Changchun University of Science and Technology, Changchun ...

The radioactive earth

International Nuclear Information System (INIS)

Plant, J.A.; Saunders, A.D.

1996-01-01

Uranium, thorium and potassium are the main elements contributing to natural terrestrial radioactivity. The isotopes 238 U, 235 U, 232 Th and 40 K decay with half-lives so long that significant amounts remain in the earth, providing a continuing source of heat. The slow decay of these isotopes also provides the basis for radiometric age dating and isotopic modelling of the evolution of the earth and its crust. There is a complex interplay between their heat production and the processes involved in crust formation. Phenomena such as volcanism, earthquakes, and large-scale hydrothermal activity associated with ore deposition reflect the dissipation of heat energy from the earth, much of which is derived from natural radioactivity. The higher levels of radioactive elements during the early history of the earth resulted in higher heat flow. All three of the radioactive elements are strongly partitioned into the continental crust, but within the crust their distribution is determined by their different chemical properties. The behaviour of U, which has two commonly occurring oxidation states, is more complex than that of Th and K. Uranium deposits are diverse, and are mostly associated with granites, acid volcanics, or detrital sedimentary rocks. The most important U deposits economically are unconformity-type ores of Proterozoic age, in which U is enriched by up to 5 x 10 6 with respect to bulk earth values. In some cases natural radioactivity can be of environmental concern. The most significant risk is posed by accumulations of radon, the gaseous daughter product of U. (author)

Prescription Pattern Analysis of Nonsteroidal Anti-inflammatory Drugs in the Northeastern Iranian Population.

Science.gov (United States)

Zeinali, Majid; Tabeshpour, Jamshid; Maziar, Seyed Vahid; Taherzadeh, Zhila; Zirak, Mohammad Reza; Sent, Danielle; Azarkhiavi, Kamal Razavi; Eslami, Saeid

2017-01-01

Inappropriate nonsteroidal anti-inflammatory drugs (NSAIDs) therapy is a common cause of actual and potential adverse effects, such as bleeding and gastrointestinal ulceration, which exacerbates the patient's medical condition and might even be life threatening. We aimed to evaluate and analyze the prescription pattern of NSAIDs in Northeastern Iranian population and also provide suggestions for a more rational prescription behavior for such drugs. In this cross-sectional retrospective study, pattern of 1-year prescriptions was inspected based on 9.3 million prescriptions from two insurance companies. Type of NSAIDs, all dispensed doses and the number of NSAIDs ordered per prescription, and the route of administration for each patient were extracted from the databases. The prescription pattern of NSAIDs was analyzed seasonally. Out of 9,303,585 prescriptions, 19.3% contained at least one NSAID. Diclofenac was the most commonly prescribed NSAID (49.21%). At least two NSAIDs were simultaneously prescribed in 7% of prescriptions. General practitioners prescribed NSAIDs more frequently (67%) than specialists. Orthopedic surgeons and internists more frequently prescribed NSAIDs in comparison with other physicians (6% and 4%, respectively). Gastroprotective agents (GPAs) were coprescribed to only 7.62% of prescriptions. The frequency of NSAIDs prescription was relatively high in Northeast of Iran. A significant number of prescriptions were associated with irrational prescribing in both coadministration of NSAIDs and GPAs and NSAIDs combination. A strategy must be developed and implemented for prescribing and rational use of medications, e.g., continuing medical education regarding the potential risks of NSAIDs, importance of their appropriate and rational use, and necessity of appropriate prescription writing regarding both content and indication.

Archean komatiite volcanism controlled by the evolution of early continents.

Science.gov (United States)

Mole, David R; Fiorentini, Marco L; Thebaud, Nicolas; Cassidy, Kevin F; McCuaig, T Campbell; Kirkland, Christopher L; Romano, Sandra S; Doublier, Michael P; Belousova, Elena A; Barnes, Stephen J; Miller, John

2014-07-15

The generation and evolution of Earth's continental crust has played a fundamental role in the development of the planet. Its formation modified the composition of the mantle, contributed to the establishment of the atmosphere, and led to the creation of ecological niches important for early life. Here we show that in the Archean, the formation and stabilization of continents also controlled the location, geochemistry, and volcanology of the hottest preserved lavas on Earth: komatiites. These magmas typically represent 50-30% partial melting of the mantle and subsequently record important information on the thermal and chemical evolution of the Archean-Proterozoic Earth. As a result, it is vital to constrain and understand the processes that govern their localization and emplacement. Here, we combined Lu-Hf isotopes and U-Pb geochronology to map the four-dimensional evolution of the Yilgarn Craton, Western Australia, and reveal the progressive development of an Archean microcontinent. Our results show that in the early Earth, relatively small crustal blocks, analogous to modern microplates, progressively amalgamated to form larger continental masses, and eventually the first cratons. This cratonization process drove the hottest and most voluminous komatiite eruptions to the edge of established continental blocks. The dynamic evolution of the early continents thus directly influenced the addition of deep mantle material to the Archean crust, oceans, and atmosphere, while also providing a fundamental control on the distribution of major magmatic ore deposits.

Cervical cancer: intracavitary dose specification and prescription

International Nuclear Information System (INIS)

Potish, R.A.; Gerbi, B.J.

1987-01-01

Dose and volume specifications for reporting intracavitary therapy were analyzed according to criteria recommended by the International Commission on Radiation Units and Measurements (ICRU). Ninety Fletcher-Suit radium applications were studied to examine the validity of the assumptions of the ICRU and the merit of their routine reporting. It was demonstrated that the reporting recommendations were inconsistent with clinical prescription systems and added little to dose specification. The distinction between dose specification and dose prescription was stressed

Differences in psychotropic drug prescriptions among ethnic groups in the Netherlands.

Science.gov (United States)

Wittkampf, Laura Christina; Smeets, Hugo M; Knol, Mirjam J; Geerlings, Mirjam I; Braam, Arjan W; De Wit, Niek J

2010-08-01

Psychotropic drug use in Europe and the USA has increased in the past 20 years. The rise in mental health-care use instigated a debate about possible differences in prevalence rates between different ethnic groups in the Netherlands, although the exact differences were unknown. The aim of this study was to determine whether these minority groups were more or less likely than the native population to receive psychotropic drugs. A descriptive population study was conducted using the Agis Health Database, containing demographic and health-care consumption data of approximately 1.5 million inhabitants of the Netherlands. Rates of prescriptions of psychotropic drugs from 2001 to 2006 and adjusted odds ratios for psychotropic drug prescriptions among native Dutch, Turkish and Moroccan ethnic groups were calculated. These data were analysed using logistic regression, after being adjusted for age, gender and socioeconomic status. The mean year prevalence of psychotropic drug prescriptions from 2001 to 2006 was 14.0%. Except for a decrease in anxiolytic drugs, the prescriptions of psychotropic drugs increased from 2001 to 2006. These trends were the same for all of the ethnic groups considered. Among both the Moroccan and Turkish populations, there was a higher risk of antidepressant and antipsychotic drug prescriptions, and a pronounced lower risk of ADHD medication and lithium prescriptions compared to the native population. Among the Turkish population, the risk of anxiolytic drug prescriptions was greater than in the native population. Compared to the native population in the Netherlands, first- and second-generation Turkish and Moroccan immigrants had an increased risk of antidepressant and antipsychotic drug prescriptions and a decreased risk of ADHD medication and Lithium prescriptions. Further research is needed to clarify whether patients of different ethnic backgrounds with the same symptoms receive similar diagnosis and adequate treatment.

Electronic prescription as contributing factor for hospitalized patients' safety.

Directory of Open Access Journals (Sweden)

Gimenes FRE

2006-03-01

Full Text Available The following study was performed to identify factors related to medication errors in the computerized physician order entry and their advantages and disadvantages according to doctors, nursing team and administrative officers. It is a survey descriptive study carried out at three units of a Brazilian academic hospital in the southeast area. The study was divided in two phases. In the first phase, we analyzed a total of 1,349 prescriptions from general medical unit, surgical and orthopaedic wards during 30 days consecutively. A semi-structured instrument, elaborated by a group of researchers for the study proposals, was used. In the second phase, a semi-structured questionnaire was applied to the health professionals containing closed and open items approaching their opinion about the composition of electronic prescription, the advantages and disadvantages of them, and their suggestions for its improvement. Out of 1,349 prescriptions observed, 17.5% presented deletions, 25.0% medicines written manually and 17.0% of them were incomplete. Some of the advantages pointed by health professionals were its legibility (37.5%, little time spent when elaborating and emitting them (20.5% and the way they are a practical and organized (8%. The disadvantages pointed were repetition of previous prescriptions (34%, typing mistakes (17%, dependence on computers (11% and alterations made manually (7%. We conclude, this way, that the computerized prescription order entry represents a great progress among the strategies used to minimize medication errors caused by prescriptions badly formulated. However, it doesn't eradicate the possibility of medication error occurrences, needing some system modifications.

A smart medication recommendation model for the electronic prescription.

Science.gov (United States)

Syed-Abdul, Shabbir; Nguyen, Alex; Huang, Frank; Jian, Wen-Shan; Iqbal, Usman; Yang, Vivian; Hsu, Min-Huei; Li, Yu-Chuan

2014-11-01

The report from the Institute of Medicine, To Err Is Human: Building a Safer Health System in 1999 drew a special attention towards preventable medical errors and patient safety. The American Reinvestment and Recovery Act of 2009 and federal criteria of 'Meaningful use' stage 1 mandated e-prescribing to be used by eligible providers in order to access Medicaid and Medicare incentive payments. Inappropriate prescribing has been identified as a preventable cause of at least 20% of drug-related adverse events. A few studies reported system-related errors and have offered targeted recommendations on improving and enhancing e-prescribing system. This study aims to enhance efficiency of the e-prescribing system by shortening the medication list, reducing the risk of inappropriate selection of medication, as well as in reducing the prescribing time of physicians. 103.48 million prescriptions from Taiwan's national health insurance claim data were used to compute Diagnosis-Medication association. Furthermore, 100,000 prescriptions were randomly selected to develop a smart medication recommendation model by using association rules of data mining. The important contribution of this model is to introduce a new concept called Mean Prescription Rank (MPR) of prescriptions and Coverage Rate (CR) of prescriptions. A proactive medication list (PML) was computed using MPR and CR. With this model the medication drop-down menu is significantly shortened, thereby reducing medication selection errors and prescription times. The physicians will still select relevant medications even in the case of inappropriate (unintentional) selection. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Patient-perceived content and formatting expectations for prescription container labeling.

Science.gov (United States)

Kebodeaux, Clark D; Peters, Golden L; Kindermann, Heather A; Hurd, Peter D; Berry, Tricia M

2016-01-01

The objectives of the study were to identify patient expectations for prescription label content and formatting and to explore how United States Pharmacopeia Chapter 17 Standards for prescription container labeling meet patient expectations. Focus group. St. Louis, Missouri, in July and August 2014. Patients 18 years and older who were taking at least 2 chronic prescription medications and managing their medications independently. Qualitative themes. Not applicable. Five focus groups (17 total participants) were conducted in St. Louis in 2014. Focus groups were audio-recorded and consent was obtained from the participants. The audio files were professionally transcribed. Atlas.ti software (version 7.5.3) was used to analyze the transcript data, which were then coded to identify key themes. To ensure consistency of interpretation, a constant comparative analytic framework approach was used. Analysis produced 6 themes related to patient perceptions and expectations of prescription label content and formatting: importance of drug name, dose, and directions; lack of side effects on the label; improved organization and larger font size; using the color red; lack of familiarity with auxiliary labels; and the importance of pharmacy information. Themes focused on how patients use prescription labels and the relative value of different aspects of prescription container labeling. Patient-perceived prescription content and formatting expectations for prescription container labeling were generally consistent with published USP Chapter 17 guidelines. The importance of pharmacy phone numbers, white space, and highlighting were noteworthy. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Sea-level and solid-Earth deformation feedbacks in ice sheet modelling

Science.gov (United States)

Konrad, Hannes; Sasgen, Ingo; Klemann, Volker; Thoma, Malte; Grosfeld, Klaus; Martinec, Zdeněk

2014-05-01

The interactions of ice sheets with the sea level and the solid Earth are important factors for the stability of the ice shelves and the tributary inland ice (e.g. Thomas and Bentley, 1978; Gomez et al, 2012). First, changes in ice extent and ice thickness induce viscoelastic deformation of the Earth surface and Earth's gravity field. In turn, global and local changes in sea level and bathymetry affect the grounding line and, subsequently, alter the ice dynamic behaviour. Here, we investigate these feedbacks for a synthetic ice sheet configuration as well as for the Antarctic ice sheet using a three-dimensional thermomechanical ice sheet and shelf model, coupled to a viscoelastic solid-Earth and gravitationally self-consistent sea-level model. The respective ice sheet undergoes a forcing from rising sea level, warming ocean, and/or changing surface mass balance. The coupling is realized by exchanging ice thickness, Earth surface deformation and sea level periodically. We apply several sets of viscoelastic Earth parameters to our coupled model, e.g. simulating a low-viscous upper mantle present at the Antarctic Peninsula (Ivins et al., 2011). Special focus of our study lies on the evolution of Earth surface deformation and local sea level changes, as well as on the accompanying grounding line evolution. N. Gomez, D. Pollard, J. X. Mitrovica, P. Huybers, and P. U. Clark 2012. Evolution of a coupled marine ice sheet-sea level model, J. Geophys. Res., 117, F01013, doi:10.1029/2011JF002128. E. R. Ivins, M. M. Watkins, D.-N. Yuan, R. Dietrich, G. Casassa, and A. Rülke 2011. On-land ice loss and glacial isostatic adjustment at the Drake Passage: 2003-2009, J. Geophys. Res. 116, B02403, doi: 10.1029/2010JB007607 R. H. Thomas and C. R. Bentley 1978. A model for Holocene retreat of the West Antarctic Ice Sheet, Quaternary Research, 10 (2), pages 150-170, doi: 10.1016/0033-5894(78)90098-4.

Medication errors: prescribing faults and prescription errors.

Science.gov (United States)

Velo, Giampaolo P; Minuz, Pietro

2009-06-01

1. Medication errors are common in general practice and in hospitals. Both errors in the act of writing (prescription errors) and prescribing faults due to erroneous medical decisions can result in harm to patients. 2. Any step in the prescribing process can generate errors. Slips, lapses, or mistakes are sources of errors, as in unintended omissions in the transcription of drugs. Faults in dose selection, omitted transcription, and poor handwriting are common. 3. Inadequate knowledge or competence and incomplete information about clinical characteristics and previous treatment of individual patients can result in prescribing faults, including the use of potentially inappropriate medications. 4. An unsafe working environment, complex or undefined procedures, and inadequate communication among health-care personnel, particularly between doctors and nurses, have been identified as important underlying factors that contribute to prescription errors and prescribing faults. 5. Active interventions aimed at reducing prescription errors and prescribing faults are strongly recommended. These should be focused on the education and training of prescribers and the use of on-line aids. The complexity of the prescribing procedure should be reduced by introducing automated systems or uniform prescribing charts, in order to avoid transcription and omission errors. Feedback control systems and immediate review of prescriptions, which can be performed with the assistance of a hospital pharmacist, are also helpful. Audits should be performed periodically.

An Evidence-Based Approach To Exercise Prescriptions on ISS

Science.gov (United States)

Ploutz-Snyder, Lori

2009-01-01

This presentation describes current exercise countermeasures and exercise equipment for astronauts onboard the ISS. Additionally, a strategy for evaluating evidence supporting spaceflight exercise is described and a new exercise prescription is proposed. The current exercise regimen is not fully effective as the ISS exercise hardware does not allow for sufficient exercise intensity, the exercise prescription is adequate and crew members are noncompliant with the prescription. New ISS hardware is proposed, Advanced Resistance Exercise Device (ARED), which allows additional exercises, is instrumented for data acquisition and offers improved loading. The new T2 hardware offers a better harness and subject loading system, is instrumented to allow ground reaction force data, and offers improved speed. A strategy for developing a spaceflight exercise prescription is described and involves identifying exercise training programs that have been shown to maximize adaptive benefits of people exercising in both 0 and 1 g environments. Exercise intensity emerged as an important factor in maintaining physiologic adaptations in the spaceflight environment and interval training is suggested. New ISS exercise hardware should allow for exercise at intensities high enough to elicit adaptive responses. Additionally, new exercise prescriptions should incorporate higher intensity exercises and seek to optimize intensity, duration and frequency for greater efficiency.

Preventing Prescription Drug Abuse in Adolescence: A Collaborative Approach

Science.gov (United States)

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

2012-01-01

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

The light-cone gauge and the principal value prescription

International Nuclear Information System (INIS)

Pimentel, B.M.; Suzuki, A.T.

1988-01-01

The principal value prescription is used to treat the unphysical pole (K.n) -1 in the basic one-loop light-cone integral. It is shown that the prescription is well suited to such a task, contrary to what has been previously thought till now. (author) [pt

Determinants of U.S. Prescription Drug Utilization using County Level Data.

Science.gov (United States)

Nianogo, Thierry; Okunade, Albert; Fofana, Demba; Chen, Weiwei

2016-05-01

Prescription drugs are the third largest component of U.S. healthcare expenditures. The 2006 Medicare Part D and the 2010 Affordable Care Act are catalysts for further growths in utilization becuase of insurance expansion effects. This research investigating the determinants of prescription drug utilization is timely, methodologically novel, and policy relevant. Differences in population health status, access to care, socioeconomics, demographics, and variations in per capita number of scripts filled at retail pharmacies across the U.S.A. justify fitting separate econometric models to county data of the states partitioned into low, medium, and high prescription drug users. Given the skewed distribution of per capita number of filled prescriptions (response variable), we fit the variance stabilizing Box-Cox power transformation regression models to 2011 county level data for investigating the correlates of prescription drug utilization separately for low, medium, and high utilization states. Maximum likelihood regression parameter estimates, including the optimal Box-Cox λ power transformations, differ across high (λ = 0.214), medium (λ = 0.942), and low (λ = 0.302) prescription drug utilization models. The estimated income elasticities of -0.634, 0.031, and -0.532 in high, medium, and low utilization models suggest that the economic behavior of prescriptions is not invariant across different utilization levels. Copyright © 2015 John Wiley & Sons, Ltd.

Pricing of prescription drugs and its impact on physicians' choice behavior.

Science.gov (United States)

Miao-Sheng, Chen; Yu-Ti, Shih

2008-09-01

This research presents an analysis of Taiwan's health care market with the focus on the pricing of prescription drugs and its impact on physicians' choice behavior. Since the advent of Taiwan's national health insurance, with the competent authority being Bureau of National Health Insurance (BNHI), hospitals are allowed to sell prescription drugs to patients at prices above the purchasing prices, so each prescription drug has two prices: one at which drugs are sold to hospitals; the other which BNHI reimbursement to hospitals. The margin between the different prices is the sales discount that pharmaceutical companies offer to the hospitals. We find that sales discount has a great impact on physicians' choice behavior: i.e., physicians are price-sensitive to prescription drugs. In addition, it is found that too high a sales discount of a prescription drug would result in a too low weighted average price of that drug sold; thus BNHI would be more likely to adjust downward the rate it reimbursement to the hospital. This presents a sales strategy problem to pharmaceutical companies. To solve this, we use the distribution of physicians' evaluations of prescription drugs to establish a profit maximization model in hopes of helping companies to price drugs and find the optimal promotion expending. Ten popular prescription drugs are used in this research as examples.

Prevalence and pattern of prescription errors in a Nigerian kidney ...

African Journals Online (AJOL)

Setting: Kidney Care Centre is a public Specialist hospital. ... Main outcome measures: Prevalence of prescription errors, pattern of prescription errors, pharmacist's intervention. ... A medication quality assurance unit is needed in our hospitals.

Analysis of prescription database extracted from standard textbooks of traditional Dai medicine.

Science.gov (United States)

Zhang, Chuang; Chongsuvivatwong, Virasakdi; Keawpradub, Niwat; Lin, Yanfang

2012-08-29

Traditional Dai Medicine (TDM) is one of the four major ethnomedicine of China. In 2007 a group of experts produced a set of seven Dai medical textbooks on this subject. The first two were selected as the main data source to analyse well recognized prescriptions. To quantify patterns of prescriptions, common ingredients, indications and usages of TDM. A relational database linking the prescriptions, ingredients, herb names, indications, and usages was set up. Frequency of pattern of combination and common ingredients were tabulated. A total of 200 prescriptions and 402 herbs were compiled. Prescriptions based on "wind" disorders, a detoxification theory that most commonly deals with symptoms of digestive system diseases, accounted for over one third of all prescriptions. The major methods of preparations mostly used roots and whole herbs. The information extracted from the relational database may be useful for understanding symptomatic treatments. Antidote and detoxification theory deserves further research.

Prescription of hazardous drugs during pregnancy.

Science.gov (United States)

Malm, Heli; Martikainen, Jaana; Klaukka, Timo; Neuvonen, Pertti J

2004-01-01

Prescribing drugs to pregnant women requires the balancing of benefits and risks. Only a small proportion of drugs are known to be harmful to the fetus, but for the vast majority of drugs little evidence of fetal safety exists. To determine the prescription pattern of potentially and clearly harmful prescription drugs during pregnancy with reference to drug safety categorisation, and to define the drug groups primarily responsible for multiple drug use during pregnancy. A retrospective, register-based cohort study. Linkage of three nationwide registers in Finland. Data collection included prescription drugs purchased during the preconception period and each trimester in the pregnant cohort, and the corresponding time periods in the non-pregnant controls. The pregnancy safety categorisation was determined for each drug (Anatomic Therapeutic Chemical [ATC] code) by using the Swedish classification of approved medicinal products (Farmaceutiska Specialiteter i Sverige [FASS]) and if not available, the corresponding Australian (Australian Drug Evaluation Committee [ADEC]) or US categorisation (FDA). GROUPS STUDIED: Women applying for maternity support (maternal grants) during the year 1999 (n = 43 470) plus non-pregnant control women matched by age and hospital district (n = 43 470). In the pregnant cohort, 20.4% of women purchased at least one drug classified as potentially harmful during pregnancy, and 3.4% purchased at least one drug classified as clearly harmful. A significant decline occurred in the number of pregnant women purchasing potentially and clearly harmful drugs during the first trimester when compared with the preconception period, and the decline continued from the first to the second trimester. In the pregnant cohort, 107 (0.2%) women purchased at least ten different drugs during pregnancy. The drugs most commonly purchased in this group were topical corticosteroids and nasal preparations. The use of hazardous prescription drugs declines during

Proscriptive versus prescriptive morality: two faces of moral regulation.

Science.gov (United States)

Janoff-Bulman, Ronnie; Sheikh, Sana; Hepp, Sebastian

2009-03-01

A distinction is made between two forms of morality on the basis of approach-avoidance differences in self-regulation. Prescriptive morality is sensitive to positive outcomes, activation-based, and focused on what we should do. Proscriptive morality is sensitive to negative outcomes, inhibition-based, and focused on what we should not do. Seven studies profile these two faces of morality, support their distinct motivational underpinnings, and provide evidence of moral asymmetry. Both are well-represented in individuals' moral repertoire and equivalent in terms of moral weight, but proscriptive morality is condemnatory and strict, whereas prescriptive morality is commendatory and not strict. More specifically, in these studies proscriptive morality was perceived as concrete, mandatory, and duty-based, whereas prescriptive morality was perceived as more abstract, discretionary, and based in duty or desire; proscriptive immorality resulted in greater blame, whereas prescriptive morality resulted in greater moral credit. Implications for broader social regulation, including cross-cultural differences and political orientation, are discussed.

An Earth-sized exoplanet with a Mercury-like composition

Science.gov (United States)

Santerne, A.; Brugger, B.; Armstrong, D. J.; Adibekyan, V.; Lillo-Box, J.; Gosselin, H.; Aguichine, A.; Almenara, J.-M.; Barrado, D.; Barros, S. C. C.; Bayliss, D.; Boisse, I.; Bonomo, A. S.; Bouchy, F.; Brown, D. J. A.; Deleuil, M.; Delgado Mena, E.; Demangeon, O.; Díaz, R. F.; Doyle, A.; Dumusque, X.; Faedi, F.; Faria, J. P.; Figueira, P.; Foxell, E.; Giles, H.; Hébrard, G.; Hojjatpanah, S.; Hobson, M.; Jackman, J.; King, G.; Kirk, J.; Lam, K. W. F.; Ligi, R.; Lovis, C.; Louden, T.; McCormac, J.; Mousis, O.; Neal, J. J.; Osborn, H. P.; Pepe, F.; Pollacco, D.; Santos, N. C.; Sousa, S. G.; Udry, S.; Vigan, A.

2018-05-01

Earth, Venus, Mars and some extrasolar terrestrial planets1 have a mass and radius that is consistent with a mass fraction of about 30% metallic core and 70% silicate mantle2. At the inner frontier of the Solar System, Mercury has a completely different composition, with a mass fraction of about 70% metallic core and 30% silicate mantle3. Several formation or evolution scenarios are proposed to explain this metal-rich composition, such as a giant impact4, mantle evaporation5 or the depletion of silicate at the inner edge of the protoplanetary disk6. These scenarios are still strongly debated. Here, we report the discovery of a multiple transiting planetary system (K2-229) in which the inner planet has a radius of 1.165 ± 0.066 Earth radii and a mass of 2.59 ± 0.43 Earth masses. This Earth-sized planet thus has a core-mass fraction that is compatible with that of Mercury, although it was expected to be similar to that of Earth based on host-star chemistry7. This larger Mercury analogue either formed with a very peculiar composition or has evolved, for example, by losing part of its mantle. Further characterization of Mercury-like exoplanets such as K2-229 b will help to put the detailed in situ observations of Mercury (with MESSENGER and BepiColombo8) into the global context of the formation and evolution of solar and extrasolar terrestrial planets.

An Earth-sized exoplanet with a Mercury-like composition

Science.gov (United States)

Santerne, A.; Brugger, B.; Armstrong, D. J.; Adibekyan, V.; Lillo-Box, J.; Gosselin, H.; Aguichine, A.; Almenara, J.-M.; Barrado, D.; Barros, S. C. C.; Bayliss, D.; Boisse, I.; Bonomo, A. S.; Bouchy, F.; Brown, D. J. A.; Deleuil, M.; Delgado Mena, E.; Demangeon, O.; Díaz, R. F.; Doyle, A.; Dumusque, X.; Faedi, F.; Faria, J. P.; Figueira, P.; Foxell, E.; Giles, H.; Hébrard, G.; Hojjatpanah, S.; Hobson, M.; Jackman, J.; King, G.; Kirk, J.; Lam, K. W. F.; Ligi, R.; Lovis, C.; Louden, T.; McCormac, J.; Mousis, O.; Neal, J. J.; Osborn, H. P.; Pepe, F.; Pollacco, D.; Santos, N. C.; Sousa, S. G.; Udry, S.; Vigan, A.

2018-03-01

Earth, Venus, Mars and some extrasolar terrestrial planets1 have a mass and radius that is consistent with a mass fraction of about 30% metallic core and 70% silicate mantle2. At the inner frontier of the Solar System, Mercury has a completely different composition, with a mass fraction of about 70% metallic core and 30% silicate mantle3. Several formation or evolution scenarios are proposed to explain this metal-rich composition, such as a giant impact4, mantle evaporation5 or the depletion of silicate at the inner edge of the protoplanetary disk6. These scenarios are still strongly debated. Here, we report the discovery of a multiple transiting planetary system (K2-229) in which the inner planet has a radius of 1.165 ± 0.066 Earth radii and a mass of 2.59 ± 0.43 Earth masses. This Earth-sized planet thus has a core-mass fraction that is compatible with that of Mercury, although it was expected to be similar to that of Earth based on host-star chemistry7. This larger Mercury analogue either formed with a very peculiar composition or has evolved, for example, by losing part of its mantle. Further characterization of Mercury-like exoplanets such as K2-229 b will help to put the detailed in situ observations of Mercury (with MESSENGER and BepiColombo8) into the global context of the formation and evolution of solar and extrasolar terrestrial planets.

Geophysical and atmospheric evolution of habitable planets.

Science.gov (United States)

Lammer, Helmut; Selsis, Frank; Chassefière, Eric; Breuer, Doris; Griessmeier, Jean-Mathias; Kulikov, Yuri N; Erkaev, Nikolai V; Khodachenko, Maxim L; Biernat, Helfried K; Leblanc, Francois; Kallio, Esa; Lundin, Richard; Westall, Frances; Bauer, Siegfried J; Beichman, Charles; Danchi, William; Eiroa, Carlos; Fridlund, Malcolm; Gröller, Hannes; Hanslmeier, Arnold; Hausleitner, Walter; Henning, Thomas; Herbst, Tom; Kaltenegger, Lisa; Léger, Alain; Leitzinger, Martin; Lichtenegger, Herbert I M; Liseau, René; Lunine, Jonathan; Motschmann, Uwe; Odert, Petra; Paresce, Francesco; Parnell, John; Penny, Alan; Quirrenbach, Andreas; Rauer, Heike; Röttgering, Huub; Schneider, Jean; Spohn, Tilman; Stadelmann, Anja; Stangl, Günter; Stam, Daphne; Tinetti, Giovanna; White, Glenn J

2010-01-01

The evolution of Earth-like habitable planets is a complex process that depends on the geodynamical and geophysical environments. In particular, it is necessary that plate tectonics remain active over billions of years. These geophysically active environments are strongly coupled to a planet's host star parameters, such as mass, luminosity and activity, orbit location of the habitable zone, and the planet's initial water inventory. Depending on the host star's radiation and particle flux evolution, the composition in the thermosphere, and the availability of an active magnetic dynamo, the atmospheres of Earth-like planets within their habitable zones are differently affected due to thermal and nonthermal escape processes. For some planets, strong atmospheric escape could even effect the stability of the atmosphere.

Tidal Friction in the Earth-Moon System and Laplace Planes: Darwin Redux

Science.gov (United States)

Rubincam, David P.

2015-01-01

The dynamical evolution of the Earth-Moon system due to tidal friction is treated here. George H. Darwin used Laplace planes (also called proper planes) in his study of tidal evolution. The Laplace plane approach is adapted here to the formalisms of W.M. Kaula and P. Goldreich. Like Darwin, the approach assumes a three-body problem: Earth, Moon, and Sun, where the Moon and Sun are point-masses. The tidal potential is written in terms of the Laplace plane angles. The resulting secular equations of motion can be easily integrated numerically assuming the Moon is in a circular orbit about the Earth and the Earth is in a circular orbit about the Sun. For Earth-Moon distances greater than 10 Earth radii, the Earth's approximate tidal response can be characterized with a single parameter, which is a ratio: a Love number times the sine of a lag angle divided by another such product. For low parameter values it can be shown that Darwin's low-viscosity molten Earth, M. Ross's and G. Schubert's model of an Earth near melting, and Goldreich's equal tidal lag angles must all give similar histories. For higher parameter values, as perhaps has been the case at times with the ocean tides, the Earth's obliquity may have decreased slightly instead of increased once the Moon's orbit evolved further than 50 Earth radii from the Earth, with possible implications for climate. This is contrast to the other tidal friction models mentioned, which have the obliquity always increasing with time. As for the Moon, its orbit is presently tilted to its Laplace plane by 5.2deg. The equations do not allow the Moon to evolve out of its Laplace plane by tidal friction alone, so that if it was originally in its Laplace plane, the tilt arose with the addition of other mechanisms, such as resonance passages.

Variations in non-prescription drug consumption and expenditure: Determinants and policy implications.

Science.gov (United States)

Otto, Monica; Armeni, Patrizio; Jommi, Claudio

2018-01-31

This paper analyses the determinants of cross-regional variations in expenditure and consumption for non-prescription drugs using the Italian Health Care Service as a case study. This research question has never been posed in other literature contributions. Per capita income, the incidence of elderly people, the presence of distribution points alternative to community pharmacies (para-pharmacies and drug corners in supermarkets), and the disease prevalence were included as possible explanatory variables. A trade-off between consumption of non-prescription and prescription-only drugs was also investigated. Correlation was tested through linear regression models with regional fixed-effects. Demand-driven variables, including the prevalence of the target diseases and income, were found to be more influential than supply-side variables, such as the presence of alternative distribution points. Hence, the consumption of non-prescription drugs appears to respond to needs and is not induced by the supply. The expected trade-off between consumption for prescription-only and non-prescription drugs was not empirically found: increasing the use of non-prescription drugs did not automatically imply savings on prescription-only drugs covered by third payers. Despite some caveats (the short period of time covered by the longitudinal data and some missing monthly data), the regression model revealed a high explanatory power of the variability and a strong predictive ability of future values. Copyright © 2018 Elsevier B.V. All rights reserved.

Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India

Directory of Open Access Journals (Sweden)

Vaishali D Phalke

2011-01-01

Full Text Available BackgroundPrescription is a written order from physician to pharmacistwhich contains name of drug, its dose and its method ofdispensing and advice over consuming it. The frequency ofdrug prescription errors is high. Prescribing errorcontributes significantly towards adverse drug events. Thepresent study was undertaken to understand the currentprescription writing practices and to detect the commonerrors in them at a tertiary health care centre situated in arural area of Western Maharashtra, India.MethodA cross sectional study was conducted at a tertiary levelhospital located at a rural area of Maharashtra state, Indiaduring October 2009-March 2010. 499 prescriptions comingto medical store during period of one month wereconsidered for data analysis. Important informationregarding the patient, doctor, drug and the generaldescription of the prescription were obtained.ResultsAll the prescriptions were on the hospital pad. A significantnumber of the prescriptions (n=88, 17.6% were written inillegible handwriting and not easily readable. The name, ageand sex of the patient were mentioned is majority of theprescriptions. All the prescriptions (100% failed todemonstrate the presence of address, height and weight ofthe patient. Only the brand name of the drugs wasmentioned in all the prescriptions with none of them havingthe generic name. The strength, quantity and route ofadministration of the drug were found on 73.1%, 65.3% and75.2% prescriptions.ConclusionThere are widespread errors in prescription writing by thedoctors. Educational intervention programs and use ofcomputer can substantially contribute in the lowering ofsuch errors. A short course on prescription writing beforethe medical student enters the clinical field and strictmonitoring by the administrative authorities may also helpalleviate the problem.Word count: 2980Tables: 2

A multileaf collimator field prescription preparation system for conventional radiotherapy

International Nuclear Information System (INIS)

Du, M.N.; Yu, C. X.; Symons, M.; Yan, D.; Taylor, R.; Matter, R.C.; Gustafson, G.; Martinez, A.; Wong, J.W.

1995-01-01

Purpose: The purpose of this work is to develop a prescription preparation system for efficient field shaping using a multileaf collimator that can be used in community settings as well as research institutions. The efficiency advantage of the computer-controlled multileaf collimator, over cerrobend blocks, to shape radiation fields has been shown in conformal treatments, which typically require complete volumetric computerized tomographic data for three-dimensional radiation treatment planning--a utility not readily available to the general community. As a result, most patients today are treated with conventional radiation therapy. Therefore, we believe that it is very important to fully use the same efficiency advantage of multileaf collimator as a block replacement in conventional practice. Methods and Material: The multileaf collimator prescription preparation system developed by us acquires prescription images from different sources, including film scanner and radiation treatment planning systems. The multileaf collimator angle and leaf positions are set from the desired field contour defined on the prescription image, by minimizing the area discrepancies. Interactive graphical tools include manual adjustment of collimator angle and leaf positions, and definition of portions of the field edges that require maximal conformation. Data files of the final leaf positions are transferred to the multileaf collimator controller via a dedicated communication link. Results: We have implemented the field prescription preparation system and a network model for integrating the multileaf collimator and other radiotherapy modalities for routine treatments. For routine plan evaluation, isodose contours measured with film in solid water phantom at prescription depth are overlaid on the prescription image. Preliminary study indicates that the efficiency advantage of the MLC over cerrobend blocks in conformal therapy also holds true for conventional treatments. Conclusion: Our

Revolutions that made the earth

CERN Document Server

Lenton, Tim

2013-01-01

The Earth that sustains us today was born out of a few remarkable, near-catastrophic revolutions, started by biological innovations and marked by global environmental consequences. The revolutions have certain features in common, such as an increase in the complexity, energy utilization, and information processing capabilities of life. This book describes these revolutions, showing the fundamental interdependence of the evolution of life and its non-living environment. We would not exist unless these upheavals had led eventually to 'successful' outcomes - meaning that after each one, at length, a new stable world emerged. The current planet-reshaping activities of our species may be the start of another great Earth system revolution, but there is no guarantee that this one will be successful. This book explains what a successful transition through it might look like, if we are wise enough to steer such a course. This book places humanity in context as part of the Earth system, using a new scientific synthe...

Northern Eurasia Earth Science Partnership Initiative: evolution of scientific investigations to applicable science

International Nuclear Information System (INIS)

Soja, Amber J; Groisman, Pavel Ya

2012-01-01

The letters collected in this focus issue of Environmental Research Letters on ‘Environmental, socio-economic and climatic changes in Northern Eurasia and their feedbacks to the global Earth system’ represent the third special issue based on the results of research within the Northern Eurasia Earth Science Partnership Initiative (NEESPI: http://neespi.org) program domain. Through the years, NEESPI researchers have presented a diverse array of articles that represent a variety of spatial scales and demonstrate the degree to which abrupt climatic and socio-economic changes are acting across Northern Eurasia and feed back to the global Earth system. (synthesis and review)

Annual review of earth and planetary sciences. Volume 16

International Nuclear Information System (INIS)

Wetherill, G.W.; Albee, A.L.; Stehli, F.G.

1988-01-01

Various papers on earth and planetary science topics are presented. The subjects addressed include: role and status of earth science field work; phase relations of prealuminous granitic rocks and their petrogenetic implications; chondritic meteorites and the solar nebula; volcanic winters; mass wasting on continental margins; earthquake ground motions; ore deposits as guides to geologic history of the earth; geology of high-level nuclear waste disposal; and tectonic evolution of the Caribbean. Also discussed are: the earth's rotation; the geophysics of a restless caldera (Long Valley, California); observations of cometary nuclei; geology of Venus; seismic stratigraphy; in situ-produced cosmogenic isotopes in terrestrial rocks; time variations of the earth's magnetic field; deep slabs, geochemical heterogeneity, and the large-scale structure of mantle convection; early proterozoic assembly and growth of Laurentia; concepts and methods of high-resolution event stratigraphy

Collective Landmarks for Deep Time: A New Tool for Evolution Education

Science.gov (United States)

Delgado, Cesar

2014-01-01

Evolution is a fundamental, organising concept in biology, yet there is widespread resistance to evolution among US students and there are rising creationist challenges in Europe. Resistance to evolution is linked to lack of understanding of the age of the Earth. An understanding of deep time is thus essential for effective biology education.…

Sales promotion by wholesalers affects general practitioners' prescription behaviours in Japan.

Science.gov (United States)

Shimura, Hirohisa

2018-01-01

Background : One method for promoting drugs in Japan has been utilizing wholesalers for promotion; however, the effectiveness of the sales promotion has been brought into question. Methods : A total of 74,552 responses were collected from an internet survey of 511 prescribing doctors in hospitals with less than 19 beds, which recalled the visits by wholesalers' sales representatives (MS) in 2014. Each assessed the degree to which MS and/or sales representatives from a pharmaceutical company (MR) influenced a decision to prescribe each drug. The responses were analysed using the chi-square test and Goodman-Kruskal's gamma to evaluate the association between MS calls and doctors' prescription orders. Results : Results showed a significant effect of the MS calls on doctors' behaviours in terms of new drug prescriptions and subsequent behaviours. The results by therapeutic category showed a similar strong influence of the joint calls on new prescriptions on some therapeutic classes. The MS calls significantly influenced doctors to maintain and increase the prescription volume (p sales promotion on the part of MSs and MRs adds value to the prescription decisions. Moreover, results suggest that MSs enhance prescription outcomes in competitive therapeutic categories.

Automated Individual Prescription of Exercise with an XML-based Expert System.

Science.gov (United States)

Jang, S; Park, S R; Jang, Y; Park, J; Yoon, Y; Park, S

2005-01-01

Continuously motivating people to exercise regularly is more important than finding a barriers such as lack of time, cost of equipment or gym membership, lack of nearby facilities and poor weather or night-time lighting. Our proposed system presents practicable methods of motivation through a web-based exercise prescription service. Users are instructed to exercise according to their physical ability by means of an automated individual prescription of exercise checked and approved by a personal trainer or exercise specialist after being tested with the HIMS, fitness assessment system. Furthermore, utilizing BIOFIT exercise prescriptions scheduled by an expert system can help users exercise systematically. Automated individual prescriptions are built in XML based documents because the data needs to be flexible, expansible and convertible structures to process diverse exercise templates. Web-based exercise prescription service makes users stay interested in exercise even if they live in many different environments.

Constitutional Block Effects of prescription of penal prosecution in Colombia

Directory of Open Access Journals (Sweden)

Luis Andrés Fajardo Arturo

2010-12-01

Full Text Available In Colombia, the articles 93, 94 and 214 of the Constitutional Charter create a bridge of implementation through the International Law of Human Rights and International Humanitarian Law are integrated into the Colombian law under the figure of the Constitutional Bloc . The main effect of this is to adapt the internal law to the international obligations of the State, and consequently, the evolution in the protection and guarantee of human rights domestically.However, the implementation process can generate complex problems that arise, for example, the contradictions between the rules of law which are based on legal principles rooted in the country and the bloc of of constitutionality’s rules. The case of prescription of prosecution in Colombia is a complex case, but international norms is evident in the existence of a rule on the applicability of prosecution of war crimes and crimes against humanity. This article is the conclusion of a balance of the principles found there.

Can antibiotic prescriptions in respiratory tract infections be improved? A cluster-randomized educational intervention in general practice – The Prescription Peer Academic Detailing (Rx-PAD Study [NCT00272155

Directory of Open Access Journals (Sweden)

Rognstad Sture

2006-06-01

Full Text Available Abstract Background More than half of all antibiotic prescriptions in general practice are issued for respiratory tract infections (RTIs, despite convincing evidence that many of these infections are caused by viruses. Frequent misuse of antimicrobial agents is of great global health concern, as we face an emerging worldwide threat of bacterial antibiotic resistance. There is an increasing need to identify determinants and patterns of antibiotic prescribing, in order to identify where clinical practice can be improved. Methods/Design Approximately 80 peer continuing medical education (CME groups in southern Norway will be recruited to a cluster randomized trial. Participating groups will be randomized either to an intervention- or a control group. A multifaceted intervention has been tailored, where key components are educational outreach visits to the CME-groups, work-shops, audit and feedback. Prescription Peer Academic Detailers (Rx-PADs, who are trained GPs, will conduct the educational outreach visits. During these visits, evidence-based recommendations of antibiotic prescriptions for RTIs will be presented and software will be handed out for installation in participants PCs, enabling collection of prescription data. These data will subsequently be linked to corresponding data from the Norwegian Prescription Database (NorPD. Individual feedback reports will be sent all participating GPs during and one year after the intervention. Main outcomes are baseline proportion of inappropriate antibiotic prescriptions for RTIs and change in prescription patterns compared to baseline one year after the initiation of the tailored pedagogic intervention. Discussion Improvement of prescription patterns in medical practice is a challenging task. A thorough evaluation of guidelines for antibiotic treatment in RTIs may impose important benefits, whereas inappropriate prescribing entails substantial costs, as well as undesirable consequences like development

Understanding Nonprescription and Prescription Drug Misuse in Late Adolescence/Young Adulthood

Directory of Open Access Journals (Sweden)

Sasha A. Fleary

2013-01-01

Full Text Available This study explored the extent to which nonprescription and prescription drugs misuse among adolescents/young adults are related to their perception that it is safer than illicit drugs, ease of access, and lower societal stigma. Adolescents/young adults (; , completed an online survey about their nonprescription and prescription drug misuse, other substance use, and correlates of use. Perceived risk, societal stigma, and access to nonprescription and prescription drugs were predictive of misuse. Results support program planners working towards targeting perceived risk and societal stigma in reducing misuse and the need to restrict and monitor access to nonprescription and prescription drugs for adolescents/young adults.

Deregulation of allopathic prescription and medical practice in India: Benefits and pitfalls

Directory of Open Access Journals (Sweden)

Raman Kumar

2016-01-01

Full Text Available In the background of debates on Universal Health Coverage, skill transfer from the medical practice license holders to other health-care providers such as nurse practitioner has become a global norm. In India, where the world's largest numbers of medical graduates are produced, this discussion is expanding to extremes and serious suggestions are coming forward for the development of legal framework for allowing dentists, homeopaths, pharmacists, and half duration trained doctors; permission to issue allopathic prescription. Allopathic medical prescription. It is noteworthy that this discussion only pertains to the pharmaceutical products retailed through “allopathic medical prescriptions.” A prescription is not only advice for patient's recovery but it also is a legitimate order for the sale of controlled drugs and pharmaceutical product; thereby functions as a regulatory tool for consumption of pharmaceutical products at retail level. Who is ultimately going to benefit from this prescription deregulation? This editorial explores benefits and pitfalls of prescription and medical practice deregulation.

Analysis of prescription database extracted from standard textbooks of traditional Dai medicine

Directory of Open Access Journals (Sweden)

Zhang Chuang

2012-08-01

Full Text Available Abstract Background Traditional Dai Medicine (TDM is one of the four major ethnomedicine of China. In 2007 a group of experts produced a set of seven Dai medical textbooks on this subject. The first two were selected as the main data source to analyse well recognized prescriptions. Objective To quantify patterns of prescriptions, common ingredients, indications and usages of TDM. Methods A relational database linking the prescriptions, ingredients, herb names, indications, and usages was set up. Frequency of pattern of combination and common ingredients were tabulated. Results A total of 200 prescriptions and 402 herbs were compiled. Prescriptions based on "wind" disorders, a detoxification theory that most commonly deals with symptoms of digestive system diseases, accounted for over one third of all prescriptions. The major methods of preparations mostly used roots and whole herbs. Conclusion The information extracted from the relational database may be useful for understanding symptomatic treatments. Antidote and detoxification theory deserves further research.

Climate evolution on the terrestrial planets

International Nuclear Information System (INIS)

Kasting, J.F.; Toon, O.B.

1989-01-01

The present comparative evaluation of the long-term evolution of the Venus, earth, and Mars climates suggests that the earth's climate has remained temperate over most of its history despite a secular solar luminosity increase in virtue of a negative-feedback cycle based on atmospheric CO 2 levels and climate. The examination of planetary climate histories suggests that an earth-sized planet should be able to maintain liquid water on its surface at orbital distances in the 0.9-1.5 AU range, comparable to the orbit of Mars; this, in turn, implies that there may be many other habitable planets within the Galaxy

21 CFR 1306.05 - Manner of issuance of prescriptions.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Manner of issuance of prescriptions. 1306.05 Section 1306.05 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE PRESCRIPTIONS... revised, effective June 1, 2010. For the convenience of the user, therevised text is set forth as follows...

Drug prescription pattern in a Nigerian Teaching Hospital | Sodipo ...

African Journals Online (AJOL)

Background: There is an increasing incidence of irrational drug use worldwide. The drug prescription pattern in Nigeria is characterised by inappropriate drug use which has led to increasing expenditure and loss of patient confidence in the health sector. This has led to calls to improve prescription patterns in Nigerian ...

The last stage of Earth's formation: Increasing the pressure

Science.gov (United States)

Lock, S. J.; Stewart, S. T.; Mukhopadhyay, S.

2017-12-01

A range of high-energy, high-angular momentum (AM) giant impacts have been proposed as a potential trigger for lunar origin. High-energy, high-AM collisions create a previously unrecognized planetary object, called a synestia. Terrestrial synestias exceed the corotation limit for a rocky planet, forming an extended structure with a corotating inner region and disk-like outer region. We demonstrate that the internal pressures of Earth-like planets do not increase monotonically during the giant impact stage, but can vary substantially in response to changes in rotation and thermal state. The internal pressures in an impact-generated synestia are much lower than in condensed, slowly rotating planets of the same mass. For example, the core-mantle boundary (CMB) pressure can be as low as 60 GPa for a synestia with Earth mass and composition, compared to 136 GPa in the present-day Earth. The lower pressures are due to the low density and rapid rotation of the post-impact structure. After a high-AM Moon-forming impact, the internal pressures in the interior of the synestia would have increased to present-day Earth values in two stages: first by vapor condensation and second by removal of AM from the Earth during the tidal evolution of the Moon. The pressure evolution of the Earth has several implications. Metal-silicate equilibration after the impact would have occurred at much lower pressures than has previously been assumed. The observed moderately siderophile element abundances in the mantle may be consistent with equilibration at the bottom of a deep, lower-pressure magma ocean. In addition, the pressure at the CMB during cooling is coincident with, or lower than, the proposed intersection of liquid adiabats with the mantle liquidus. The mantle would hence freeze from the bottom up and there would be no basal magma ocean. The subsequent pressure increase and tidal heating due to the Moon's orbital evolution likely induces melting in the lowermost mantle. Increasing

Prescription drugs purchased through the internet: who are the end users?

Science.gov (United States)

Inciardi, James A; Surratt, Hilary L; Cicero, Theodore J; Rosenblum, Andrew; Ahwah, Candice; Bailey, J Elise; Dart, Richard C; Burke, John J

2010-07-01

Although prescription drugs are readily available on the Internet, little is known about the prevalence of Internet use for the purchase of medications without a legitimate prescription, and the characteristics of those that obtain non-prescribed drugs through online sources. The scientific literature on this topic is limited to anecdotal reports or studies plagued by small sample sizes. Within this context, the focus of this paper is an examination of five national data sets from the U.S. with the purpose of estimating: (1) how common obtaining prescription medications from the Internet actually is, (2) who are the typical populations of "end users" of these non-prescribed medications, and (3) which drugs are being purchased without a prescription. Three of the data sets are drawn from the RADARS (Researched Abuse Diversion and Addiction-Related Surveillance) System, a comprehensive series of studies designed to collect timely and geographically specific data on the abuse and diversion of a number of prescription stimulants and opioid analgesics. The remaining data sets include the National Survey on Drug Use and Health (NSDUH) and the Monitoring the Future (MTF) survey. Our analysis yielded uniformly low rates of prescription drug acquisition from online sources across all five data systems we examined. The consistency of this finding across very diverse populations suggests that the Internet is a relatively minor source for illicit purchases of prescription medications by the individual end-users of these drugs. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Study on drug costs associated with COPD prescription medicine in Denmark.

Science.gov (United States)

Jakobsen, Marie; Anker, Niels; Dollerup, Jens; Poulsen, Peter Bo; Lange, Peter

2013-10-01

Spirometric studies of the general population estimate that 430 000 Danes have chronic obstructive pulmonary disease (COPD). COPD is mainly caused by smoking, and smoking cessation is the most important intervention to prevent disease progression. Cost-of-illness studies conclude that the costs associated with COPD in Denmark are significant, but costs of prescription medicine for COPD were not analysed. To analyse the societal costs associated with prescription medicine for COPD in Denmark. The study was designed as a nationwide retrospective register study of the drug costs (ATC group R03) associated with COPD in the period 2001-2010. Data were retrieved from the Prescription Database, the National Patient Register and the Centralised Civil Register. The population comprised individuals (40+ years) who had at least one prescription of selected R03 drugs and who had been either hospitalised with a COPD diagnosis or had at least one prescription for drugs primarily used for COPD. The study population comprised 166 462 individuals of which 97 916 were alive on 31 December 2010. The average annual drug costs (R03) were DKK 7842 (EUR 1055) per patient in 2010 with total costs of DKK 685 million (EUR 92 million). The average lifetime costs associated with COPD prescription medicine were estimated to be DKK 70 000-75 000 (EUR 9416-10 089) per patient (2010 prices). The costs associated with prescription medicine for COPD in Denmark are significant. © 2012 John Wiley & Sons Ltd.

Pharmacy Customers’ Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland

Science.gov (United States)

Timonen, Johanna; Ahonen, Riitta

2018-01-01

Background One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. Objective The aim of this study was to investigate Finnish pharmacy customers’ (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Methods Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers’ experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Results Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when

[Antibiotic prescription usage and assessment in geriatric patients].

Science.gov (United States)

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

2016-01-01

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

Controversy in Purchasing Prescription Drugs Online in China.

Science.gov (United States)

Yuan, Peng; Qi, Lin; Wang, Long

2016-08-01

China's government is considering legalization of online prescription drugs to increase the pharmaceutical market and enhance access to necessary medicines. However, challenges such as a shortage of licensed pharmacists and drug quality issues have raised concerns and delayed consensus on the proposal. China's government must address the most pressing issues so it can render a decision on online prescription sales. Copyright © 2016 Elsevier Ltd. All rights reserved.

Prescription of anorectic and benzodiazepine drugs through notification B prescriptions in Natal, Rio Grande do Norte, Brazil

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Solange Aparecida Nappo

2010-06-01

Full Text Available A study was conducted on 22,158 special B prescriptions (notificações B containing amphetamine-type anorectic drugs or benzodiazepines, obtained from compounding pharmacies or drugstores located in the city of Natal, RN, Brazil. The data obtained were compared with those from other Brazilian cities. Results showed that compounding pharmacies dispensed 85.4% of the prescriptions, indicating that these pharmacies filled out nearly 10 times more of these prescriptions than did the drugstores. The majority (83.5% of B prescriptions issued for the compounding pharmacies were for women, where the female/male patient ratio ranged from 7.1/1.0 for mazindol to 10.3/1.0 for amfepramone. Similar results were obtained for the benzodiazepines with ratios of 1.9/1.0 for clonazepam to 15.6/1.0 for oxazepam. Omissions and mistakes were present in the B prescriptions, including missing information about the patient (in 49.6% of the documents or about the pharmacies or drugstores (50.4%. There were cases where the name and/or CRM of the physician was lacking. It was noted that one medical doctor made out 1855 B prescriptions within one year. The same patient's name appeared on 138 prescriptions, and the same RG (identification card number was present in 125 others. Comparison of Natal's data with those of several other Brazilian cities disclosed a striking similarity throughout Brazil, from Pelotas - Rio Grande do Sul State to Belem-Para State, revealing a practically identical medical/pharmaceutical behavior. This pattern of prescription/dispensation of amphetamine-type substances mostly to women for weight loss is therefore for cosmetic reasons. Consequently, there is an urgent need for an ethical review of this behavior.Foram examinadas 22.158 notificações B contendo substâncias anoréticas tipo-anfetamina ou de benzodiazepínicos, obtidas de drogarias e de farmácias de manipulação. Os dados foram comparados com os de outras cidades do Brasil, obtendo

Social network analysis of duplicative prescriptions: One-month analysis of medical facilities in Japan.

Science.gov (United States)

Takahashi, Yoshimitsu; Ishizaki, Tatsuro; Nakayama, Takeo; Kawachi, Ichiro

2016-03-01

Duplicative prescriptions refer to situations in which patients receive medications for the same condition from two or more sources. Health officials in Japan have expressed concern about medical "waste" resulting from this practices. We sought to conduct descriptive analysis of duplicative prescriptions using social network analysis and to report their prevalence across ages. We analyzed a health insurance claims database including 1.24 million people from December 2012. Through social network analysis, we examined the duplicative prescription networks, representing each medical facility as nodes, and individual prescriptions for patients as edges. The prevalence of duplicative prescription for any drug class was strongly correlated with its frequency of prescription (r=0.90). Among patients aged 0-19, cough and colds drugs showed the highest prevalence of duplicative prescriptions (10.8%). Among people aged 65 and over, antihypertensive drugs had the highest frequency of prescriptions, but the prevalence of duplicative prescriptions was low (0.2-0.3%). Social network analysis revealed clusters of facilities connected via duplicative prescriptions, e.g., psychotropic drugs showed clustering due to a few patients receiving drugs from 10 or more facilities. Overall, the prevalence of duplicative prescriptions was quite low - less than 10% - although the extent of the problem varied by drug class and age group. Our approach illustrates the potential utility of using a social network approach to understand these practices. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The Montaguto earth flow: nine years of observation and analysis

Science.gov (United States)

Guerriero, L.; Revellino, R; Grelle, G.; Diodato, N; Guadagno, F.M.; Coe, Jeffrey A.

2016-01-01

This paper summarizes the methods, results, and interpretation of analyses carried out between 2006 and 2015 at the Montaguto earth flow in southern Italy. We conducted a multi-temporal analysis of earth-flow activity to reconstruct the morphological and structural evolution of the flow. Data from field mapping were combined with a geometric reconstruction of the basal slip surface in order to investigate relations between basal-slip surface geometry and deformation styles of earth-flow material. Moreover, we reconstructed the long-term pattern of earth-flow movement using both historical observations and modeled hydrologic and climatic data. Hydrologic and climatic data were used to develop a Landslide Hydrological Climatological (LHC) indicator model.

An automated technique to identify potential inappropriate traditional Chinese medicine (TCM) prescriptions.

Science.gov (United States)

Yang, Hsuan-Chia; Iqbal, Usman; Nguyen, Phung Anh; Lin, Shen-Hsien; Huang, Chih-Wei; Jian, Wen-Shan; Li, Yu-Chuan

2016-04-01

Medication errors such as potential inappropriate prescriptions would induce serious adverse drug events to patients. Information technology has the ability to prevent medication errors; however, the pharmacology of traditional Chinese medicine (TCM) is not as clear as in western medicine. The aim of this study was to apply the appropriateness of prescription (AOP) model to identify potential inappropriate TCM prescriptions. We used the association rule of mining techniques to analyze 14.5 million prescriptions from the Taiwan National Health Insurance Research Database. The disease and TCM (DTCM) and traditional Chinese medicine-traditional Chinese medicine (TCMM) associations are computed by their co-occurrence, and the associations' strength was measured as Q-values, which often referred to as interestingness or life values. By considering the number of Q-values, the AOP model was applied to identify the inappropriate prescriptions. Afterwards, three traditional Chinese physicians evaluated 1920 prescriptions and validated the detected outcomes from the AOP model. Out of 1920 prescriptions, 97.1% of positive predictive value and 19.5% of negative predictive value were shown by the system as compared with those by experts. The sensitivity analysis indicated that the negative predictive value could improve up to 27.5% when the model's threshold changed to 0.4. We successfully applied the AOP model to automatically identify potential inappropriate TCM prescriptions. This model could be a potential TCM clinical decision support system in order to improve drug safety and quality of care. Copyright © 2016 John Wiley & Sons, Ltd.

NASA's Evolution to K(sub a)- Band Space Communications for Near-Earth Spacecraft

Science.gov (United States)

McCarthy, Kevin P.; Stocklin, Frank J.; Geldzahler, Barry J.; Friedman, Daniel E.; Celeste, Peter B.

2010-01-01

Over the next several years, NASA plans to launch multiple earth-science missions which will send data from low-Earth orbits to ground stations at 1-3 Gbps, to achieve data throughputs of 5-40 terabits per day. These transmission rates exceed the capabilities of S-band and X-band frequency allocations used for science probe downlinks in the past. Accordingly, NASA is exploring enhancements to its space communication capabilities to provide the Agency's first Ka-band architecture solution for next generation missions in the near-earth regime. This paper describes the proposed Ka-band solution's drivers and concept, constraints and analyses which shaped that concept, and expansibility for future needs

O aparelho pré-ajustado: sua evolução e suas prescrições The pre-adjusted appliance: evolution and prescriptions

Directory of Open Access Journals (Sweden)

Vicente de Sousa Brito Júnior

2006-06-01

Full Text Available Este trabalho revisou as prescrições de braquetes pré-ajustados existentes no mercado, abordando as variações dos valores de inclinação, angulação e rotação dentária. A revisão reporta desde a origem do conceito de uso de arcos retangulares em acessórios com secções retangulares até os atuais modelos de braquetes autoligados e outros braquetes com formatos diferenciados.This research intended to review all the available prescriptions of pre-adjusted orthodontic appliances in the market and to discuss the justification of the authors as to the prescribed angulation, inclination and rotation suggested. The review encompassed the rectangular wire application in Edgewise brackets, until the implementation of self ligation, and many other kinds of brackets with distinct shapes according to the utilized technique. It was clear the great variety of many orthodontic mechanotherapy and brackets prescriptions, demonstrating that Orthodontics is a science with many possible alternatives.

RFI and Remote Sensing of the Earth from Space

Science.gov (United States)

Le Vine, D. M.; Johnson, J. T.; Piepmeier, J.

2016-01-01

Passive microwave remote sensing of the Earth from space provides information essential for understanding the Earth's environment and its evolution. Parameters such as soil moisture, sea surface temperature and salinity, and profiles of atmospheric temperature and humidity are measured at frequencies determined by the physics (e.g. sensitivity to changes in desired parameters) and by the availability of suitable spectrum free from interference. Interference from manmade sources (radio frequency interference) is an impediment that in many cases limits the potential for accurate measurements from space. A review is presented here of the frequencies employed in passive microwave remote sensing of the Earth from space and the associated experience with RFI.

Future Challenges and Opportunities in Online Prescription Drug Promotion Research

Science.gov (United States)

Southwell, Brian G.; Rupert, Douglas J.

2016-01-01

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

Heat-pipe Earth.

Science.gov (United States)

Moore, William B; Webb, A Alexander G

2013-09-26

The heat transport and lithospheric dynamics of early Earth are currently explained by plate tectonic and vertical tectonic models, but these do not offer a global synthesis consistent with the geologic record. Here we use numerical simulations and comparison with the geologic record to explore a heat-pipe model in which volcanism dominates surface heat transport. These simulations indicate that a cold and thick lithosphere developed as a result of frequent volcanic eruptions that advected surface materials downwards. Declining heat sources over time led to an abrupt transition to plate tectonics. Consistent with model predictions, the geologic record shows rapid volcanic resurfacing, contractional deformation, a low geothermal gradient across the bulk of the lithosphere and a rapid decrease in heat-pipe volcanism after initiation of plate tectonics. The heat-pipe Earth model therefore offers a coherent geodynamic framework in which to explore the evolution of our planet before the onset of plate tectonics.

Trends in direct-to-consumer advertising of prescription contraceptives.

Science.gov (United States)

Wu, Min H; Bartz, Deborah; Avorn, Jerry; Seeger, John D

2016-05-01

Despite much speculation about the role of direct-to-consumer advertising (DTCA) in increasing demand for prescription contraceptives in the United States, there is little published research on this topic. We sought to quantify the prevalence and magnitude of DTCA for prescription contraceptives over the last decade. Using cross-sectional data from January 2005 through December 2014, we performed descriptive analyses on trends in DTCA expenditure for prescription contraceptives. We also quantified the amount of DTCA according to contraceptive method category and individual brand. During the study period, pharmaceutical companies spent a total of US$1.57 billion in the United States on DTCA of prescription contraceptives. Annual expenditure for contraceptive DTCA reached a peak value of US$260 million in 2008, with a progressive decline to a nadir of US$69 million by 2013. Of the contraceptive methods, oral contraceptive pills (OCPs) have been the most heavily promoted, with Yaz (drospirenone/ethinyl estradiol) - the most advertised brand - accounting for US$347 million of cumulative DTCA expenditure. However, DTCA spending on OCPs peaked in 2007 and was overtaken in 2012 by the DTCA of long-acting reversible contraceptives (LARCs), the contraceptive method now receiving the largest amount of DTCA promotion. DTCA is a major form of promotion for prescription contraceptives. Recent trends in DTCA expenditure indicate a shift from promotion of the OCPs to the LARCs. DTCA's effect on provider and patient utilization of various contraceptive methods has yet to be determined. This study provides the first quantitative evaluation of DTCA of prescription contraceptive methods and reveals DTCA's importance as a form of promotion. Recent DTCA trends indicate increased promotion of LARCs, coinciding with greater uptake of LARC methods by patients and prescribers. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of Internally Developed Electronic Prescription on Prescribing Errors at Discharge from the Emergency Department.

Science.gov (United States)

Hitti, Eveline; Tamim, Hani; Bakhti, Rinad; Zebian, Dina; Mufarrij, Afif

2017-08-01

Medication errors are common, with studies reporting at least one error per patient encounter. At hospital discharge, medication errors vary from 15%-38%. However, studies assessing the effect of an internally developed electronic (E)-prescription system at discharge from an emergency department (ED) are comparatively minimal. Additionally, commercially available electronic solutions are cost-prohibitive in many resource-limited settings. We assessed the impact of introducing an internally developed, low-cost E-prescription system, with a list of commonly prescribed medications, on prescription error rates at discharge from the ED, compared to handwritten prescriptions. We conducted a pre- and post-intervention study comparing error rates in a randomly selected sample of discharge prescriptions (handwritten versus electronic) five months pre and four months post the introduction of the E-prescription. The internally developed, E-prescription system included a list of 166 commonly prescribed medications with the generic name, strength, dose, frequency and duration. We included a total of 2,883 prescriptions in this study: 1,475 in the pre-intervention phase were handwritten (HW) and 1,408 in the post-intervention phase were electronic. We calculated rates of 14 different errors and compared them between the pre- and post-intervention period. Overall, E-prescriptions included fewer prescription errors as compared to HW-prescriptions. Specifically, E-prescriptions reduced missing dose (11.3% to 4.3%, p prescriptions, however, were associated with a significant increase in duplication errors, specifically with home medication (1.7% to 3%, p=0.02). A basic, internally developed E-prescription system, featuring commonly used medications, effectively reduced medication errors in a low-resource setting where the costs of sophisticated commercial electronic solutions are prohibitive.

Urban Evolution: the Role of Water

Science.gov (United States)

The structure, function, and services of urban ecosystems evolve over time scales from seconds to centuries as Earth's population grows, infrastructure ages, and sociopolitical values alter them. In order to systematically study changes over time, the concept of "urban evolution...

Technical Note: Dose gradients and prescription isodose in orthovoltage stereotactic radiosurgery

International Nuclear Information System (INIS)

Fagerstrom, Jessica M.; Bender, Edward T.; Culberson, Wesley S.

2016-01-01

Purpose: The purpose of this work is to examine the trade-off between prescription isodose and dose gradients in orthovoltage stereotactic radiosurgery. Methods: Point energy deposition kernels (EDKs) describing photon and electron transport were calculated using Monte Carlo methods. EDKs were generated from 10  to 250 keV, in 10 keV increments. The EDKs were converted to pencil beam kernels and used to calculate dose profiles through isocenter from a 4π isotropic delivery from all angles of circularly collimated beams. Monoenergetic beams and an orthovoltage polyenergetic spectrum were analyzed. The dose gradient index (DGI) is the ratio of the 50% prescription isodose volume to the 100% prescription isodose volume and represents a metric by which dose gradients in stereotactic radiosurgery (SRS) may be evaluated. Results: Using the 4π dose profiles calculated using pencil beam kernels, the relationship between DGI and prescription isodose was examined for circular cones ranging from 4 to 18 mm in diameter and monoenergetic photon beams with energies ranging from 20 to 250 keV. Values were found to exist for prescription isodose that optimize DGI. Conclusions: The relationship between DGI and prescription isodose was found to be dependent on both field size and energy. Examining this trade-off is an important consideration for designing optimal SRS systems.

A microcomputer system for prescription, calculation, verification and recording of radiotherapy treatments

International Nuclear Information System (INIS)

Morrey, D.; Smith, C.W.; Belcher, R.A.; Harding, T.; Sutherland, W.H.

1982-01-01

The design of a microcomputer system for the reduction of mistakes in radiotherapy is described. The system covers prescription entry, prescription and treatment calculations, and verification and recording of the treatment set-up. A telecobalt unit was interfaced to the system and in the first 12 months 400 patients have been prescribed and 5000 treatment fields verified. The prescription is entered by the medical officer using an interactive program and this prescription provides the reference for verifying the treatment set-up. The program allows amendments to the prescription to be made easily during the treatment course. The treatment parameters verified are field size, wedge and treatment time. The system uses bar-codes for patient and field identification. A reduction in the number of mistakes has been achieved and future developments are discussed. (author)

Do coxibs reduce prescription of gastroprotective agents? Results of a record linkage study

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Violante Andrea

2006-03-01

Full Text Available Abstract Background Coxibs are claimed to be cost-effective drugs and reduced prescription of gastroprotective agents is assumed to be one of their major benefits. Real life prescription of these drugs may be substantially different than that considered in pharmacoeconomic analyses or claimed by drug companies, yet. Our objective was to evaluate whether coxibs were associated with reduced prescription of gastro-protective agents (GPAs, specifically proton pump inhibitors, H2 blockers and misoprostol compared to non selective NSAIDs. Methods A record-linkage study was performed using 2001 outpatient prescription data from the province of Modena (about 632,000 inhabitants, in Northern Italy. Logistic regression was used to calculate the odds ratio of GPA prescription for coxib and non-selective NSAID adult users (> 14 years. Three categories of users were further investigated: "acute", "chronic and "incident or new". Main outcome measures were same-day co-prescription and 30 days prescription of GPAs in coxibs and non selective NSAIDs users. To limit selection bias, data were adjusted for age, sex, DDD of coxibs and non selective NSAIDs received during 2001, DDD of GPAs and (for non-incident users DDD of NSAIDs received during the previous 4 years Results Same day co-prescription rates were similar considering the overall population and "acute" users. Chronic coxibs users instead showed higher co-prescription rates than chronic NSAIDs users (OR = 1.2, p Conclusion Assumptions made in pharmacoeconomic analyses on coxibs (lower GPA prescription associated with coxibs use may be overly optimistic. Claims made through cost-effectiveness data should be carefully interpreted, and mechanisms for attributing drug prices revised accordingly.

Investigating the exercise-prescription practices of nurses working in inpatient mental health settings.

Science.gov (United States)

Stanton, Robert; Happell, Brenda; Reaburn, Peter

2015-04-01

Nurses working in mental health are well positioned to prescribe exercise to people with mental illness. However, little is known regarding their exercise-prescription practices. We examined the self-reported physical activity and exercise-prescription practices of nurses working in inpatient mental health facilities. Thirty-four nurses completed the Exercise in Mental Illness Questionnaire - Health Practitioner Version. Non-parametric bivariate statistics revealed no relationship between nurses' self-reported physical activity participation and the frequency of exercise prescription for people with mental illness. Exercise-prescription parameters used by nurses are consistent with those recommended for both the general population and for people with mental illness. A substantial number of barriers to effective exercise prescription, including lack of training, systemic issues (such as prioritization and lack of time), and lack of consumer motivation, impact on the prescription of exercise for people with mental illness. Addressing the barriers to exercise prescription could improve the proportion of nurses who routinely prescribe exercise. Collaboration with exercise professionals, such as accredited exercise physiologists or physiotherapists, might improve knowledge of evidence-based exercise-prescription practices for people with mental illness, thereby improving both physical and mental health outcomes for this vulnerable population. © 2015 Australian College of Mental Health Nurses Inc.

Astrobiology: Life on Earth (and Elsewhere?)

Science.gov (United States)

Des Marais, David J.

2016-01-01

Astrobiology investigates the origins, evolution and distribution of life in the universe. Scientists study how stellar systems and their planets can create planetary environments that sustain biospheres. They search for biosignatures, which are objects, substances and or patterns that indicate the presence of life. Studies of Earth's early biosphere enhance these search strategies and also provide key insights about our own origins.

Diversity of Physicians’ Handwriting and Name Stamp in Chemotherapy Prescriptions: Potential Target for Fraud

Directory of Open Access Journals (Sweden)

Asiyeh Amouei

2018-02-01

Full Text Available BBackgrounds: Verification and authentication of the paper-based handwritten prescriptions is of great importance for antineoplastic medications that are good targets for forgery and fraud. Pharmacists usually investigate handwriting, signature and name stamp of prescribers to verify prescriptions in Iran. Anecdotal reports of variations in handwriting and name stamp of physicians who wrote antineoplastic prescriptions raised concerns in this regard. The aim of the study was to investigate the reported diversity and evaluate the quality of writing physician identity and required items in antineoplastic prescriptions.Methods: All insured hand-written prescriptions contained at least one antineoplastic medication and were dispensed by four main authorized community pharmacies dispensing antineoplastic medications in Tehran during one month were included. Prescriptions that were written by specialties other than oncology-related fields were excluded. Prescriptions of each physician were evaluated considering handwriting and name stamp by experienced pharmacy staff and the frequency of detected handwriting and name stamp types was recorded.Results: Of the 11022 included prescriptions, 10944 were eligible and written by 241 physicians. Median (third quartile number of physicians’ prescriptions was 17 (51. Maximum number of observed handwriting and name stamp types were eight and six respectively. High prescribers tended to have several handwriting and name stamp types.Conclusion: The observed diversity and variation in handwriting and name stamp of the physicians in antineoplastic prescriptions may facilitate the entrance of forged prescription and makes fraud detection difficult. Administrative and regulatory interventions in addition to notification of health care professionals about the observed potential might be necessary.

Comparison of provincial prescription drug plans and the impact on patients' annual drug expenditures.

Science.gov (United States)

Demers, Virginie; Melo, Magda; Jackevicius, Cynthia; Cox, Jafna; Kalavrouziotis, Dimitri; Rinfret, Stéphane; Humphries, Karin H; Johansen, Helen; Tu, Jack V; Pilote, Louise

2008-02-12

Reimbursement for outpatient prescription drugs is not mandated by the Canada Health Act or any other federal legislation. Provincial governments independently establish reimbursement plans. We sought to describe variations in publicly funded provincial drug plans across Canada and to examine the impact of this variation on patients' annual expenditures. We collected information, accurate to December 2006, about publicly funded prescription drug plans from all 10 Canadian provinces. Using clinical scenarios, we calculated the impact of provincial cost-sharing strategies on individual annual drug expenditures for 3 categories of patients with different levels of income and 2 levels of annual prescription burden ($260 and $1000). We found that eligibility criteria and cost-sharing details of the publicly funded prescription drug plans differed markedly across Canada, as did the personal financial burden due to prescription drug costs. Seniors pay 35% or less of their prescription costs in 2 provinces, but elsewhere they may pay as much as 100%. With few exceptions, nonseniors pay more than 35% of their prescription costs in every province. Most social assistance recipients pay 35% or less of their prescription costs in 5 provinces and pay no costs in the other 5. In an example of a patient with congestive heart failure, his out-of-pocket costs for a prescription burden of $1283 varied between $74 and $1332 across the provinces. Considerable interprovincial variation in publicly funded prescription drug plans results in substantial variation in annual expenditures by Canadians with identical prescription burdens. A revised pharmaceutical strategy might reduce these major inequities.

Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland.

Science.gov (United States)

Lämsä, Elina; Timonen, Johanna; Ahonen, Riitta

2018-02-23

One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. The aim of this study was to investigate Finnish pharmacy customers' (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers' experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when acting on behalf of another person (25

Pharmaceutical interventions on prescription problems in a Danish pharmacy setting

DEFF Research Database (Denmark)

Pottegård, Anton; Hallas, Jesper; Søndergaard, Jens

2011-01-01

International studies regarding pharmacists' interventions towards prescription problems produce highly variable results. The only peer-reviewed study in a Danish setting estimated an intervention rate of 2.3 per 1,000 prescriptions. With the introduction of a new tool for registration, we...

A security and privacy preserving e-prescription system based on smart cards.

Science.gov (United States)

Hsu, Chien-Lung; Lu, Chung-Fu

2012-12-01

In 2002, Ateniese and Medeiros proposed an e-prescription system, in which the patient can store e-prescription and related information using smart card. Latter, Yang et al. proposed a novel smart-card based e-prescription system based on Ateniese and Medeiros's system in 2004. Yang et al. considered the privacy issues of prescription data and adopted the concept of a group signature to provide patient's privacy protection. To make the e-prescription system more realistic, they further applied a proxy signature to allow a patient to delegate his signing capability to other people. This paper proposed a novel security and privacy preserving e-prescription system model based on smart cards. A new role, chemist, is included in the system model for settling the medicine dispute. We further presented a concrete identity-based (ID-based) group signature scheme and an ID-based proxy signature scheme to realize the proposed model. Main property of an ID-based system is that public key is simple user's identity and can be verified without extra public key certificates. Our ID-based group signature scheme can allow doctors to sign e-prescription anonymously. In a case of a medical dispute, identities of the doctors can be identified. The proposed ID-based proxy signature scheme can improve signing delegation and allows a delegation chain. The proposed e-prescription system based on our proposed two cryptographic schemes is more practical and efficient than Yang et al.'s system in terms of security, communication overheads, computational costs, practical considerations.

Moving Closer to EarthScope: A Major New Initiative for the Earth Sciences*

Science.gov (United States)

Simpson, D.; Blewitt, G.; Ekstrom, G.; Henyey, T.; Hickman, S.; Prescott, W.; Zoback, M.

2002-12-01

EarthScope is a scientific research and infrastructure initiative designed to provide a suite of new observational facilities to address fundamental questions about the evolution of continents and the processes responsible for earthquakes and volcanic eruptions. The integrated observing systems that will comprise EarthScope capitalize on recent developments in sensor technology and communications to provide Earth scientists with synoptic and high-resolution data derived from a variety of geophysical sensors. An array of 400 broadband seismometers will spend more than ten years crossing the contiguous 48 states and Alaska to image features that make up the internal structure of the continent and underlying mantle. Additional seismic and electromagnetic instrumentation will be available for high resolution imaging of geological targets of special interest. A network of continuously recording Global Positioning System (GPS) receivers and sensitive borehole strainmeters will be installed along the western U.S. plate boundary. These sensors will measure how western North America is deforming, what motions occur along faults, how earthquakes start, and how magma flows beneath active volcanoes. A four-kilometer deep observatory bored directly into the San Andreas fault will provide the first opportunity to observe directly the conditions under which earthquakes occur, to collect fault rocks and fluids for laboratory study, and to monitor continuously an active fault zone at depth. All data from the EarthScope facilities will be openly available in real-time to maximize participation from the scientific community and to provide on-going educational outreach to students and the public. EarthScope's sensors will revolutionize observational Earth science in terms of the quantity, quality and spatial extent of the data they provide. Turning these data into exciting scientific discovery will require new modes of experimentation and interdisciplinary cooperation from the Earth

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science; Volume 125; Issue 8 ... in conformity with their relation to (earthquake induced) shear system evolution in this terrain. ... Sanjoy Mahato1 Arka Ranjan Jana1 P B Maithani3 P V Ramesh Babu3.

Emigrating Beyond Earth Human Adaptation and Space Colonization

CERN Document Server

Smith, Cameron M

2012-01-01

For four million years humankind has been actively expanding geographically and in doing so has adapted to a wide variety of hostile environments. Now we are looking towards the ultimate adaptation - the colonization of space. Emigrating Beyond Earth illustrates that this is not a technocratic endeavor, but a natural continuation of human evolution; a journey not just for the engineer and rocket scientist, but for everyman. Based on the most current understanding of our universe, human adaptation and evolution, the authors explain why space colonization must be planned as an adaptation to, rather than the conquest of, space. Emigrating Beyond Earth argues that space colonization is an insurance policy for our species, and that it isn't about rockets and robots, it's about humans doing what we've been doing for four million years: finding new places and new ways to live. Applying a unique anthropological approach, the authors outline a framework for continued human space exploration and offer a glimpse of a po...

Geodynamics of kimberlites on a cooling Earth: Clues to plate tectonic evolution and deep volatile cycles

Science.gov (United States)

Tappe, Sebastian; Smart, Katie; Torsvik, Trond; Massuyeau, Malcolm; de Wit, Mike

2018-02-01

Kimberlite magmatism has occurred in cratonic regions on every continent. The global age distribution suggests that this form of mantle melting has been more prominent after 1.2 Ga, and notably between 250-50 Ma, than during early Earth history before 2 Ga (i.e., the Paleoproterozoic and Archean). Although preservation bias has been discussed as a possible reason for the skewed kimberlite age distribution, new treatment of an updated global database suggests that the apparent secular evolution of kimberlite and related CO2-rich ultramafic magmatism is genuine and probably coupled to lowering temperatures of Earth's upper mantle through time. Incipient melting near the CO2- and H2O-bearing peridotite solidus at >200 km depth (1100-1400 °C) is the petrologically most feasible process that can produce high-MgO carbonated silicate melts with enriched trace element concentrations akin to kimberlites. These conditions occur within the convecting asthenospheric mantle directly beneath thick continental lithosphere. In this transient upper mantle source region, variable CHO volatile mixtures control melting of peridotite in the absence of heat anomalies so that low-degree carbonated silicate melts may be permanently present at ambient mantle temperatures below 1400 °C. However, extraction of low-volume melts to Earth's surface requires tectonic triggers. Abrupt changes in the speed and direction of plate motions, such as typified by the dynamics of supercontinent cycles, can be effective in the creation of lithospheric pathways aiding kimberlite magma ascent. Provided that CO2- and H2O-fluxed deep cratonic keels, which formed parts of larger drifting tectonic plates, existed by 3 Ga or even before, kimberlite volcanism could have been frequent during the Archean. However, we argue that frequent kimberlite magmatism had to await establishment of an incipient melting regime beneath the maturing continents, which only became significant after secular mantle cooling to below

Prescription drug overdose: between patients and their doctors

Directory of Open Access Journals (Sweden)

Ling W

2013-01-01

Full Text Available Walter Ling,1 Li-Tzy Wu21Department of Psychiatry and Biobehavioral Science, Integrated Substance Abuse Programs, University of California, Los Angeles, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USAPrescription drug overdoses, mainly involving prescription opioids, have reached epidemic proportions in the United States over the past 20 years.1,2 Since 2003, prescription opioids have been involved in more drug-related overdose deaths than heroin and cocaine combined. Among patients who were prescribed opioids, an estimated 20% were prescribed high doses of opioids by either single or multiple physicians, and these patients appeared to account for the majority of prescription opioid-related overdoses.1,3,4 The increase in prescription overdose deaths has coincided with a major increase in prescription opioid sales.2 The prescribing practices of some physicians are often believed to have contributed in part to the increase in these overdose deaths. In a recently published perspective, Anna Lembke speculated on why doctors prescribe opioids to known prescription opioid abusers.5 Her article raises a timely and troubling issue for all of us interested in this area of medicine. Lembke identifies the root of the problem to lie in the changing societal attitude towards pain and suffering, the ever-growing availability of opioid medications, the regulatory requirements promulgated, and the perceived shift in the role of the medical professional in this context. Central to her argument is that physicians must now practice according to a set of externally imposed expectations of patients, payers, and regulators, putting the prescriber in the position of being "damned if you do and damned if you don’t". If Lembke is right, the physician now prescribes not according to what he or she wants to do, but according to what he or she must do. The result, at one extreme, is the patient acting as their

Symbiosis in cell evolution: Life and its environment on the early earth

Science.gov (United States)

Margulis, L.

1981-01-01

The book treats cell evolution from the viewpoint of the serial endosymbiosis theory of the origin of organelles. Following a brief outline of the symbiotic theory, which holds that eukaryotes evolved by the association of free-living bacteria with a host prokaryote, the diversity of life is considered, and five kingdoms of organisms are distinguished: the prokaryotic Monera and the eukaryotic Protoctista, Animalia, Fungi and Plantae. Symbiotic and traditional direct filiation theories of cell evolution are compared. Recent observations of cell structure and biochemistry are reviewed in relation to early cell evolution, with attention given to the geological context for the origin of eukaryotic cells, the origin of major bacterial anaerobic pathways, the relationship between aerobic metabolism and atmospheric oxygen, criteria for distinguishing symbiotic organelles from those that originated by differentiation, and the major classes of eukaryotic organelles: mitochondria, cilia, microtubules, the mitotic and meiotic apparatuses, and pastids. Cell evolution during the Phanerozoic is also discussed with emphasis on the effects of life on the biosphere

Dispensing of drugs with and without a prescription from private ...

African Journals Online (AJOL)

There is little literature available on dispensing patterns and unsupervised sale of medicines from pharmacies in Tanzania. The present study assessed the patterns of drug acquisition from pharmacies by customers: whether by prescription, recommended by pharmacist, or requested by a customer without a prescription.

Earth's Coming of Age: Isotopically Tracking the Global Transformation from the Hadean to the Geologically Modern Earth

Science.gov (United States)

Bennett, V. C.; Nutman, A. P.

2017-12-01

Some of the strongest direct evidence that documents fundamental changes in the chemistry and organisation of Earth's interior derives from radiogenic isotopic compositions that include both long-lived (particularly 176Lu-176Hf and 147Sm-143Nd) and short-lived, i.e., now extinct parent isotope, systems (182Hf-182W, 146Sm-142Nd). Changes in patterns of isotopic evolution are linked to changes in mantle dynamics such that tracking these signatures in geologically well-characterised rocks can be used to discover the the nature and evolution of tectonic processes. Over the past decade, intensive geochemical investigations by various groups focussing on the oldest (> 4.0 Ga to 3.6 Ga) rock record, as preserved in several localities, have revealed isotopic distinctions in the early Earth compared with those in Proterozoic and younger rocks. For example, whilst the major and trace element compositions of Eoarchean gneisses have analogs in younger rocks in accord with a continuum of crust formation processes, radiogenic isotopic signatures from both long and short half-life decay schemes record an image of the Earth in transition from early differentiation processes, likely associated with planetary accretion and formation, to more modern style characterised by plate tectonics. The emerging image is that many Eoarchean rocks possess extinct nuclide anomalies in the form of 142Nd and 182Hf isotopic signatures that are absent in modern terrestrial samples; these signatures are evidence of chemical fractionation processes occuring within the first ca. 10-300 million years of Solar System history. In addition, viewing the global database, patterns of long-half life isotope signatures i.e., 143Nd and 176Hf differ from those seen in younger (modern Earth.

Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas.

Science.gov (United States)

Harris, Shana; Nikulina, Valentina; Gelpí-Acosta, Camila; Morton, Cory; Newsome, Valerie; Gunn, Alana; Hoefinger, Heidi; Aikins, Ross; Smith, Vivian; Barry, Victoria; Downing, Martin J

2015-12-02

Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion) of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Data were drawn from a cross-sectional Internet study ( N = 846) of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Findings suggest that predictive characteristics vary according to diverter group.

Manipulation of prescriptions by patients - what must a doctor do?

Science.gov (United States)

DeSousa, Avinash

2016-01-01

Over-the-counter use of medication via chemists, including the use of psychiatric medication, has always been a cause of worry in the Indian subcontinent. Over the last two years, the rules on dispensing psychiatric medication have become stringent and chemists have to dispense the exact amount of medicine written on the prescription for the time duration mentioned. The chemist also stamps the prescription with the amount of medicine dispensed so that the patient does not use the prescription at another chemist's or counter to obtain more than the amount prescribed. This means that patients must follow up with the psychiatrist regularly, have themselves evaluated, and get a fresh prescription that must be signed by the doctor and also carry his seal. There are many patients who do not adhere to this rule. Many a time, chemists who have known a patient over the years tend to continue dispensing medication to the patient for durations which far exceed that prescribed by the doctor. This is rather dangerous as the patient may end up taking antidepressants, antipsychotics and sedatives for months or at times, years, without a valid prescription. They may also develop side-effects that could ensue under unsupervised consumption.

Prescription pain medications and chronic headache in Denmark

DEFF Research Database (Denmark)

Westergaard, Maria Lurenda; Hansen, Ebba Holme; Glümer, Charlotte

2015-01-01

, tramadol, ibuprofen and codeine. CH was associated with osteoarthritis, back pain, and rheumatoid arthritis. Among those with MOH, 32.4 % were dispensed an opioid at least once within 1 year. Only 5.1 % of people with CH were dispensed triptans. CONCLUSIONS: High prevalence of opioid use among people......PURPOSE: The aim of the present paper is to study which prescription pain medications are most commonly dispensed to people with chronic headache (CH), particularly those with medication-overuse headache (MOH). METHODS: This cross-sectional study analysed prescription pain medications dispensed...... within 1 year to 68,518 respondents of a national health survey. Participants with headache ≥15 days per month for 3 months were classified as having CH. Those with CH and over-the-counter analgesic use ≥15 days per month or purchase of ≥20 or ≥30 defined daily doses (DDDs) of prescription pain...

Antibiotic prescription strategies for acute sore throat: a prospective observational cohort study.

Science.gov (United States)

Little, Paul; Stuart, Beth; Hobbs, F D Richard; Butler, Chris C; Hay, Alastair D; Delaney, Brendan; Campbell, John; Broomfield, Sue; Barratt, Paula; Hood, Kerenza; Everitt, Hazel; Mullee, Mark; Williamson, Ian; Mant, David; Moore, Michael

2014-03-01

Data from trials suggest that antibiotics reduce the risk of complications of sore throat by at least 50%, but few trials for complications have been done in modern settings, and datasets of delayed antibiotic prescription are underpowered. Observational evidence is important in view of poor compliance with antibiotic treatment outside trials, but no prospective observational cohort studies have been done to date. We generated a large prospective cohort from the DESCARTE study, and the PRISM component of DESCARTE, of 12,829 adults presenting with sore throat (≤ 2 weeks duration) in primary care. Our follow-up of the cohort was based on a detailed and structured review of routine medical records, and analysis of the comparison of three antibiotic prescription strategies (no antibiotic prescription, immediate antibiotic prescription, and delayed antibiotic prescription) to control for the propensity to prescribe antibiotics. Information about antibiotic prescription was recorded in 12,677 individuals (4805 prescribed no antibiotics, 6088 prescribed antibiotics immediately, and 1784 prescribed delayed antibiotics). We documented by review of patients' notes (n=11,950) the development of suppurative complications (eg, quinsy, impetigo and cellulitis, otitis media, and sinusitis) or reconsultation with new or non-resolving symptoms). We used multivariate analysis to control for variables significantly related to the propensity to prescribe antibiotics and for clustering by general practitioner. 164 (1.4%) of the 11,950 patients with information available developed complications; otitis media and sinusitis were the most common complications (101 patients [62%]). Compared with no antibiotic prescription, immediate antibiotic prescription was associated with fewer complications (adjusted risk ratio [RR] 0.62, 95% CI 0.43-0.91, estimated number needed to treat [NNT 193) as was delayed prescription of antibiotics (0.58, 0.34-0.98; NNT 174). 1787 of the 11,950 patients (15

Automated prescription of oblique brain 3D magnetic resonance spectroscopic imaging.

Science.gov (United States)

Ozhinsky, Eugene; Vigneron, Daniel B; Chang, Susan M; Nelson, Sarah J

2013-04-01

Two major difficulties encountered in implementing Magnetic Resonance Spectroscopic Imaging (MRSI) in a clinical setting are limited coverage and difficulty in prescription. The goal of this project was to automate completely the process of 3D PRESS MRSI prescription, including placement of the selection box, saturation bands and shim volume, while maximizing the coverage of the brain. The automated prescription technique included acquisition of an anatomical MRI image, optimization of the oblique selection box parameters, optimization of the placement of outer-volume suppression saturation bands, and loading of the calculated parameters into a customized 3D MRSI pulse sequence. To validate the technique and compare its performance with existing protocols, 3D MRSI data were acquired from six exams from three healthy volunteers. To assess the performance of the automated 3D MRSI prescription for patients with brain tumors, the data were collected from 16 exams from 8 subjects with gliomas. This technique demonstrated robust coverage of the tumor, high consistency of prescription and very good data quality within the T2 lesion. Copyright © 2012 Wiley Periodicals, Inc.

Corrosion properties and corrosion evolution of as-cast AZ91 alloy with rare earth yttrium

International Nuclear Information System (INIS)

Luo, T.J.; Yang, Y.S.

2011-01-01

Highlights: → Minor addition of Y will increase the corrosion resistance of AZ91 alloy, and 0.3 wt.% Y is the optimum addition. → A film composed of Mg(OH) 2 , MgCO 3 , Al(OH) 3 and Al 2 O 3 is formed on the surface of AZ91 alloy with rare earth Y free. → The film of AZ91 alloy with 0.3 wt.% Y is mainly composed of Mg(OH) 2 and MgCO 3 without any Al(OH) 3 and Al 2 O 3 . → The relative quantity of MgCO 3 in the surface film of AZ91 + 0.3 wt.% Y is bigger than that of AZ91 alloy with Y free. → Y 2 O 3 phase is found in the surface film of alloy III, which benefits to stabilize the surface film. -- Abstract: The corrosion resistance property and the corrosion evolution of as-cast AZ91 alloy with rare earth Y addition are investigated by using immersion tests, electrochemical impedance spectroscopy (EIS), and X-ray photoelectron spectroscopy (XPS). The results show that the proper amount of Y in the alloys can improve the corrosion resistance of AZ91 alloys effectively. With the increment of Y, the corrosion rate of the modified AZ91 alloys by Y addition was markedly less than that of AZ91 alloy. The corrosion rate of AZ91 alloy with 0.3 wt.% Y was the slightest, but further addition of Y content over 0.3 wt.% make the corrosion heavier. The XPS analysis suggests that the compound film of AZ91 alloy with 0.3 wt.% Y is mainly composed of Mg(OH) 2 and MgCO 3 without any Al(OH) 3 and Al 2 O 3 , in addition, Y 2 O 3 phase is found in the compound film of AZ91 alloy with 0.3 wt.% Y, which benefits to stabilize the surface film.

Direct-to-consumer advertising of prescription medicines: a counter argument.

Science.gov (United States)

Mintzes, Barbara; Mangin, Dee

2009-12-01

Direct-to-consumer advertising of prescription-only medicines is currently only permitted in the USA and New Zealand. Barbara Mintzes and Dee Mangin provide their case against direct-to-consumer advertising of prescription medicines, arguing that its wider introduction would lead to a 'Pharma-knows-best' culture.

US veterans use vitamins and supplements as substitutes for prescription medication.

Science.gov (United States)

Goldstein, Jennifer N; Long, Judith A; Arevalo, Doris; Ibrahim, Said A; Mao, Jun J

2014-12-01

Vitamins and supplements are the most commonly used form of complementary and alternative medicine in the United States. Growing research suggests that patients substitute vitamins and supplements for their prescription medications. The reasons might include cost of prescription medications and discordant patient and doctor health belief systems. To investigate the prevalence of substitution of vitamins and supplements for prescription medications among veterans who receive care in the VA health care system and whether substitution is associated with prescription rationing due to cost, treatment beliefs, or distrust of the health system. Cross-sectional observational survey. Primary care patients (n=275) at the Philadelphia VA Medical Center. Medication substitution, prescription medication rationing, treatment beliefs, and health system distrust were measured with structured instruments. Multivariate logistic regression was performed with substitution as the dependent variable. A significant number of primary care patients in the VA system use vitamins and supplements 206 (75%). The prevalence of medication substitution is high 48 (18%). Medication substitution is strongly associated with prescription rationing due to cost (adjusted odds ratio 6.3, 95% confidence interval: 2.0-19.5, P=0.001). Similarly, greater belief in complementary and alternative approaches to care positively predicts medication substitution (adjusted odds ratio 1.08, 95% confidence interval: 1.01-1.15, P=0.011). There is no significant association between health system distrust and likelihood of medication substitution. Medication substitution is prevalent in this sample of inner city primary care patients who receive care in the VA system. Cost of prescriptions and belief in the value of complementary and alternative approaches to care appear to be associated with this patient-driven treatment decision.

Elaboration and Validation of the Medication Prescription Safety Checklist 1

Science.gov (United States)

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

2017-01-01

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

Safety of non-prescription medicines: knowledge and attitudes of Italian pharmacy customers.

Science.gov (United States)

Cuzzolin, Laura; Benoni, Giuseppina

2010-02-01

A survey was designed to investigate customers attitudes and knowledge toward non-prescription medicines taken on a self-medication basis but not devoid of risks. Community pharmacies in Italy. Forty-four pharmacies participated in the project. On the basis of an anonymous questionnaire, face-to-face interviews were made to customers buying a non-prescription medicine over a 2-month period. The questionnaire included information about socio-demographic characteristics of the interviewed subjects and 18 items designed to elicit information about the kind of medicine purchased and reason of use, general product knowledge in relation to quality and risks, attitudes toward this kind of drugs, concurrent prescription drug use and the quality of relationship with the pharmacist. During the study period, 613 interviews were collected. The most frequently non-prescription medicines purchased by customers were non-steroidal anti-inflammatory drugs, paracetamol and medicines for gastrointestinal problems. The most of interviewees referred to read carefully the package inserts or to ask information to pharmacists. Moreover, they reported to consider non-prescription medicines easy to manage and to be used only for minor ailments and for short periods. 55.3% of customers reported to have been taking at least a prescription drug, mostly antihypertensives or other cardiovascular medicines, in association with non-prescription medicines. In this situation, interviewees often did not inform pharmacists about chronic therapies. Our interviews demonstrate that, in general, Italian customers have a cautious approach toward non-prescription medicines and are informed on their use. However, in case of a long-term use, interviewees underestimate risks related to possible physiological/pathological changes in their organism or to interactions with other drugs.

Prescription Omega-3 Fatty Acid Products and Dietary Supplements Are Not Interchangeable.

Science.gov (United States)

Hilleman, Daniel; Smer, Aiman

2016-01-01

To provide an overview of prescription and dietary supplement omega-3 fatty acid (OM3-FA) products and considerations for clinical use. Narrative review. The PubMed database was searched for cardiovascular-related investigations focused on eicosapentaenoic acid (EPA) and/or docosahexaenoic acid (DHA) (limit: English-only articles). Additional regulatory information on prescription and dietary supplements was obtained from United States Food and Drug Administration online sources. Prescription QM3-FA products are supported by robust clinical development and safety monitoring programs, whereas dietary supplements are not required to demonstrate safety or efficacy prior to marketing. There are no over-the-counter OM3-FA products available in the United States. Investigations of OM3-FA dietary supplements show that quantities of EPA and DHA are highly variable within and between brands. Dietary supplements also may contain potentially harmful components, including oxidized OM3-FA, other lipids, cholesterol, and toxins. Prescription OM3-FA products may contain DHA and EPA or EPA alone. All prescription OM3-FA products have demonstrated statistically significant triglyceride reduction as monotherapy or in combination with statins in patients with hypertriglyceridemia. Differential effects between products containing EPA and DHA compared with a high-purity EPA product (icosapent ethyl) have clinical implications: Increases in low-density lipoprotein cholesterol associated with DHA have the potential to confound strategies for managing patients with dyslipidemia. Cardiovascular outcomes studies of prescription CM3-FA products are ongoing. OM3-FA dietary supplements should not be substituted for prescription products, and prescription OM3-FA products that contain DHA are not equivalent to or interchangeable with high-purity EPA (icosapent ethyl) and should not be substituted for it.

Mucosal dose prescription in endobronchial brachytherapy: a study based on CT-dosimetry

International Nuclear Information System (INIS)

Lagerwaard, Frank J.; Murrer, Lars H.P.; Pan, Connie de; Roos, Martin; Senan, Suresh

2000-01-01

Purpose: To investigate the consequences of using different dose prescription methods for endobronchial brachytherapy (EB), both with and without the use of a centered applicator. Materials and Methods: A CT scan was performed during EB procedures in 13 patients after insertion of the lung applicator. A dosimetric analysis was subsequently performed in five of these patients using a 3D-brachytherapy treatment planning system (PLATO v13.3, Nucletron). Results: Dose prescription to the mucosa yields uniform dose distributions to the bronchial mucosa when a centrally positioned applicator is used. When non-centrally positioned applicators are used, mucosal dosing results in a significant underdosage to parts of the target volume. Due to the rapid dose fall-off in EB, dose prescription to the mucosa resulted in inadequate coverage of the outer portion of the bronchial wall and adjacent peribronchial space. When compared to mucosal dose prescription, prescription to the outer aspect of the bronchial wall appears to improve target coverage while limiting the hyperdose (i.e., 200%) volume. The diameters of the different bronchial segments, as determined by CT measurements in 13 patients, correlated well with calculated values based upon the tracheal diameter. Conclusions: Mucosal dose prescription should only be used in combination with centered EB applicators. Given the rapid dose fall-off in EB mucosal dose prescription should be used with caution in curative treatments where EB, without additional external radiotherapy, is used as the sole treatment modality. In curative EB, both improved target coverage and a limited hyperdose volume can be achieved by dose prescription to the outer aspect of the bronchial wall

Medicare Prescription Drug Coverage - General Information

Data.gov (United States)

U.S. Department of Health & Human Services — The MMA legislation provides seniors and people with disabilities with the first comprehensive prescription drug benefit ever offered under the Medicare program, the...

Behavioural screening of zebrafish using neuroactive traditional Chinese medicine prescriptions and biological targets

Science.gov (United States)

Wang, Ya-Nan; Hou, Yuan-Yuan; Sun, Ming-Zhu; Zhang, Chun-Yang; Bai, Gang; Zhao, Xin; Feng, Xi-Zeng

2014-06-01

The mechanism of the therapeutic action of antidepressants remains uncertain in traditional Chinese medicine (TCM). In this study, we selected 7 classical TCM prescriptions and utilised an automatic video-tracking system to monitor the rest/wake behaviour of larval zebrafish at 4 days post-fertilisation (dpf) for 48 hours. We found that the curative effects of the prescriptions were dose-dependent. K-means clustering was performed according to the shared behavioural phenotypes of the zebrafish. The results revealed that the rest/wake behavioural profiles induced by the same class of prescriptions were similar. A correlation analysis was conducted between the TCM prescriptions and the known compounds. The results showed that the TCM prescriptions correlated well with some well-known compounds. Therefore, we predicted that they may share a similar mechanism of action. This paper describes the first study to combine TCM research with zebrafish rest/wake behaviour in vivo and presents a powerful approach for the discovery of the mechanism of action of TCM prescriptions.

Validity of the Prescriber Information in the Danish National Prescription Registry

DEFF Research Database (Denmark)

Rasmussen, Lotte; Valentin, Julie; Gesser, Katarina Margareta

2016-01-01

The aim of this study was to measure the validity of the prescriber information recorded in the Danish National Prescription Registry (DNPR). The prescriber information recorded in the pharmacies' electronic dispensing system was considered to represent the prescriber information recorded...... in the DNPR. Further, the problem of validity of the prescriber information pertains only to non-electronic prescriptions, as these are manually entered into the dispensing system. The recorded prescriber information was thus validated against information from a total of 2,000 non-electronic prescriptions...... at five Danish community pharmacies. The validity of the recorded prescriber information was measured at the level of the individual prescriber and the prescriber type, respectively. The proportion of non-electronic prescriptions with incorrect registrations was 22.4% (95% Confidence Interval (CI): 20...

Prescription Drug Diversion: Predictors of Illicit Acquisition and Redistribution in Three U.S. Metropolitan Areas

Directory of Open Access Journals (Sweden)

Shana Harris

2015-12-01

Full Text Available Objective: Prescription drug diversion, the transfer of prescription drugs from lawful to unlawful channels for distribution or use, is a problem in the United States. Despite the pervasiveness of diversion, there are gaps in the literature regarding characteristics of individuals who participate in the illicit trade of prescription drugs. This study examines a range of predictors (e.g., demographics, prescription insurance coverage, perceived risk associated with prescription drug diversion of membership in three distinct diverter groups: individuals who illicitly acquire prescription drugs, those who redistribute them, and those who engage in both behaviors. Methods: Data were drawn from a cross-sectional Internet study (N = 846 of prescription drug use and diversion patterns in New York City, South Florida, and Washington, D.C.. Participants were classified into diversion categories based on their self-reported involvement in the trade of prescription drugs. Group differences in background characteristics of diverter groups were assessed by Chi-Square tests and followed up with multivariate logistic regressions. Results: While individuals in all diversion groups were more likely to be younger and have a licit prescription for any of the assessed drugs in the past year than those who did not divert, individuals who both acquire and redistribute are more likely to live in New York City, not have prescription insurance coverage, and perceive fewer legal risks of prescription drug diversion. Conclusion: Findings suggest that predictive characteristics vary according to diverter group.

Parental contribution to over prescription of antibiotics for sore throat ...

African Journals Online (AJOL)

Introduction: Antibiotics are often prescribed by physicians for sore throat in children because of the danger of post streptococcal complications. The role of the parents in over prescription of antibiotics is less well known. Objective: To evaluate the knowledge, attitudes and practice of parents to antibiotic prescription for ...

Prescription headache medication in OEF/OIF veterans: results from the Women Veterans Cohort Study.

Science.gov (United States)

Seng, Elizabeth K; Driscoll, Mary A; Brandt, Cynthia A; Bathulapalli, Harini; Goulet, Joseph; Silliker, Norman; Kerns, Robert D; Haskell, Sally G

2013-09-01

To examine differences in male and female veterans of Operations Enduring Freedom/Iraqi Freedom (OEF/OIF) period of service in taking prescription headache medication, and associations between taking prescription headache medication and mental health status, psychiatric symptoms, and rates of traumatic events. Headaches are common among active service members and are associated with impairment in quality of life. Little is known about headaches in OEF/OIF veterans. Veterans participating in the Women Veterans Cohort Study responded to a cross-sectional survey to assess taking prescription headache medication, mental health status (Post Deployment Health Assessment), psychiatric symptoms (portions of the Brief Patient Health Questionnaire and the Posttraumatic Stress Disorder Checklist), and traumatic events (the Traumatic Life Events Questionnaire and queries regarding military trauma). Gender differences among taking prescription headache medication, health status, psychiatric symptoms, and traumatic events were examined. Regression analyses were used to examine the influence of gender on the associations between taking prescription headache medication and health status, psychiatric symptoms, and traumatic events. 139/551 (25.2%) participants reported taking prescription headache medication in the past year. A higher proportion of women veterans (29.1%) reported taking prescription medication for headache in the last year compared with men (19.7%). Taking prescription headache medication was associated with poorer perceived mental health status, higher anxiety and posttraumatic stress disorder symptoms, and higher rates of traumatic events. The association between prescription headache medication use and perceived mental health status, and with the association between prescription headache medication use and posttraumatic stress disorder symptoms, was stronger for men than for women. Among OEF/OIF veterans, the prevalence of clinically relevant headache is high

Isotope composition and volume of Earth's early oceans.

Science.gov (United States)

Pope, Emily C; Bird, Dennis K; Rosing, Minik T

2012-03-20

Oxygen and hydrogen isotope compositions of Earth's seawater are controlled by volatile fluxes among mantle, lithospheric (oceanic and continental crust), and atmospheric reservoirs. Throughout geologic time the oxygen mass budget was likely conserved within these Earth system reservoirs, but hydrogen's was not, as it can escape to space. Isotopic properties of serpentine from the approximately 3.8 Ga Isua Supracrustal Belt in West Greenland are used to characterize hydrogen and oxygen isotope compositions of ancient seawater. Archaean oceans were depleted in deuterium [expressed as δD relative to Vienna standard mean ocean water (VSMOW)] by at most 25 ± 5‰, but oxygen isotope ratios were comparable to modern oceans. Mass balance of the global hydrogen budget constrains the contribution of continental growth and planetary hydrogen loss to the secular evolution of hydrogen isotope ratios in Earth's oceans. Our calculations predict that the oceans of early Earth were up to 26% more voluminous, and atmospheric CH(4) and CO(2) concentrations determined from limits on hydrogen escape to space are consistent with clement conditions on Archaean Earth.

Prescription Pain Medicines - An Addictive Path?

Science.gov (United States)

... the brain affected by heroin, morphine, and prescription painkillers. The tablets relieve drug cravings without prompting the same intense high or dangerous side effects. When combined with naloxone, buprenorphine's abuse potential is ...

Medical Marijuana Users are More Likely to Use Prescription Drugs Medically and Nonmedically.

Science.gov (United States)

Caputi, Theodore L; Humphreys, Keith

2018-04-17

Previous studies have found a negative population-level correlation between medical marijuana availability in US states, and trends in medical and nonmedical prescription drug use. These studies have been interpreted as evidence that use of medical marijuana reduces medical and nonmedical prescription drug use. This study evaluates whether medical marijuana use is a risk or protective factor for medical and nonmedical prescription drug use. Simulations based upon logistic regression analyses of data from the 2015 National Survey on Drug Use and Health were used to compute associations between medical marijuana use, and medical and nonmedical prescription drug use. Adjusted risk ratios (RRs) were computed with controls added for age, sex, race, health status, family income, and living in a state with legalized medical marijuana. Medical marijuana users were significantly more likely (RR 1.62, 95% confidence interval [CI] 1.50-1.74) to report medical use of prescription drugs in the past 12 months. Individuals who used medical marijuana were also significantly more likely to report nonmedical use in the past 12 months of any prescription drug (RR 2.12, 95% CI 1.67-2.62), with elevated risks for pain relievers (RR 1.95, 95% CI 1.41-2.62), stimulants (RR 1.86, 95% CI 1.09-3.02), and tranquilizers (RR 2.18, 95% CI 1.45-3.16). Our findings disconfirm the hypothesis that a population-level negative correlation between medical marijuana use and prescription drug harms occurs because medical marijuana users are less likely to use prescription drugs, either medically or nonmedically. Medical marijuana users should be a target population in efforts to combat nonmedical prescription drug use.

E-prescription as a tool for improving services and the financial viability of healthcare systems: the case of the Greek national e-prescription system.

Science.gov (United States)

Pangalos, G; Sfyroeras, V; Pagkalos, I

2014-01-01

E-prescription systems can help improve patient service, safety and quality of care. They can also help achieve better compliance for the patients and better alignment with the guidelines for the practitioners. The recently implemented national e-prescription system in Greece already covers approximately 85% of all prescriptions prescribed in Greece today (approximately 5.5 million per month). The system has not only contributed already in significant changes towards improving services and better monitoring and planning of public health, but also substantially helped to contain unnecessary expenditure related to medication use and improve transparency and administrative control. Such issues have gained increasing importance not only for Greece but also for many other national healthcare systems that have to cope with the continuous rise of medication expenditure. Our implementation has, therefore, shown that besides their importance for improving services, national e-prescription systems can also provide a valuable tool for better utilisation of resources and for containing unnecessary healthcare costs, thus contributing to the improvement of the financial stability and viability of the overall healthcare system.

Prescription Painkiller Overdoses PSA (:60)

Centers for Disease Control (CDC) Podcasts

This 60 second public service announcement is based on the July 2013 CDC Vital Signs report. Prescription painkiller overdoses are an under-recognized and growing problem among women. This program includes things that women and health care providers can do to reduce the risk of overdose.

Evolution Inclusions and Variation Inequalities for Earth Data Processing II Differential-operator Inclusions and Evolution Variation Inequalities for Earth Data Processing

CERN Document Server

Zgurovsky, Mikhail Z; Kasyanov, Pavlo O

2011-01-01

Here, the authors present modern mathematical methods to solve problems of differential-operator inclusions and evolution variation inequalities which may occur in fields such as geophysics, aerohydrodynamics, or fluid dynamics. For the first time, they describe the detailed generalization of various approaches to the analysis of fundamentally nonlinear models and provide a toolbox of mathematical equations. These new mathematical methods can be applied to a broad spectrum of problems. Examples of these are phase changes, diffusion of electromagnetic, acoustic, vibro-, hydro- and seismoacousti

Race-Ethnicity and Prescription Drug Misuse: Does Self-esteem Matter?

Science.gov (United States)

Broman, Clifford L; Miller, Paula K; Jackson, Emmanuel

2015-01-01

The research here investigates race-ethnicity and self-esteem in the misuse of prescription drugs. While there has been much research into the demographic factors that predict prescription drug misuse (PDM), we lack a full accounting of psychosocial factors of possible importance in influencing patterns of race-ethnicity and PDM. One possible influence is self-esteem. We use data from the National Longitudinal Survey on Adolescent Health to investigate race-ethnicity, PDM and self-esteem. Findings indicate first that race-ethnicity is significant is PDM. Secondly, results indicate that self-esteem is important in understanding patterns of prescription drug misuse among young adults, but only among whites.

Analysis of Potential Drug-Drug Interactions and Its Clinical Manifestation of Pediatric Prescription on 2 Pharmacies in Bandung

Directory of Open Access Journals (Sweden)

Melisa I. Barliana

2013-09-01

Full Text Available The potential of Drug-Drug Interactions (DDI in prescription have high incidence around the world, including Indonesia. However, scientific evidence regarding DDI in Indonesia is not available. Therefore, in this study we have conducted survey in 2 pharmacies in Bandung against pediatric prescription given by pediatrician. These prescriptions then analyzed the potential for DDI contained in the prescription and clinical manifestation. The analysis showed that in pharmacy A, there are 33 prescriptions (from a total of 155 prescriptions that have potential DDI, or approximately 21.19% (2 prescriptions have the potential DDI major categories, 23 prescriptions categorized as moderate, and 8 prescriptions as minor. In Pharmacy B, there are 6 prescriptions (from a total of 40 prescriptions or 15% of potential DDI (4 prescriptions categorized as moderate and 2 prescriptions as minor. This result showed that potential DDI happened less than 50% in pediatric prescription from both pharmacies. However, this should get attention because DDI should not happen in a prescription considering its clinical manifestations caused by DDI. Moreover, current pharmaceutical care refers to patient oriented than product oriented. In addition, further study for the pediatric prescription on DDI incidence in large scale need to be investigated.

The Supply of Prescription Opioids: Contributions of Episodic-Care Prescribers and High-Quantity Prescribers.

Science.gov (United States)

Schneberk, Todd; Raffetto, Brian; Kim, David; Schriger, David L

2018-06-01

We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program. We took a 10% random sample of all patients and stratified them by the amount of prescription opioids obtained during their maximal 90-day period. We identified "episodic prescribers" as those whose prescribing pattern included short-acting opioids on greater than 95% of all prescriptions, fewer than or equal to 31 pills on 95% of all prescriptions, only 1 prescription in the database for greater than 90% of all patients to whom they gave opioids, fewer than 6 prescriptions in the database to greater than 99% of patients given opioids, and fewer than 540 prescriptions per year. We identified top 5% prescribers by their morphine milligram equivalents per day in the database. We examined the relationship between patient opioid prescriptions and provider type, with the primary analysis performed on the patient cohort who received only short-acting opioids in an attempt to avoid guideline-concordant palliative, oncologic, and addiction care, and a secondary analysis performed on all patients. Among patients with short-acting opioid only, episodic prescribers (14.6% of 173,000 prescribers) wrote at least one prescription to 25% of 2.7 million individuals but were responsible for less than 9% of the 10.5 million opioid prescriptions and less than 3% of the 3.9 billion morphine milligram equivalents in our sample. Among individuals with high morphine milligram equivalents use, episodic prescribers were responsible for 2.8% of prescriptions and 0.6% of total morphine milligram equivalents

On the chronology of lunar origin and evolution. Implications for Earth, Mars and the Solar System as a whole

Science.gov (United States)

Geiss, Johannes; Rossi, Angelo Pio

2013-11-01

An origin of the Moon by a Giant Impact is presently the most widely accepted theory of lunar origin. It is consistent with the major lunar observations: its exceptionally large size relative to the host planet, the high angular momentum of the Earth-Moon system, the extreme depletion of volatile elements, and the delayed accretion, quickly followed by the formation of a global crust and mantle. According to this theory, an impact on Earth of a Mars-sized body set the initial conditions for the formation and evolution of the Moon. The impact produced a protolunar cloud. Fast accretion of the Moon from the dense cloud ensured an effective transformation of gravitational energy into heat and widespread melting. A "Magma Ocean" of global dimensions formed, and upon cooling, an anorthositic crust and a mafic mantle were created by gravitational separation. Several 100 million years after lunar accretion, long-lived isotopes of K, U and Th had produced enough additional heat for inducing partial melting in the mantle; lava extruded into large basins and solidified as titanium-rich mare basalt. This delayed era of extrusive rock formation began about 3.9 Ga ago and may have lasted nearly 3 Ga. A relative crater count timescale was established and calibrated by radiometric dating (i.e., dating by use of radioactive decay) of rocks returned from six Apollo landing regions and three Luna landing spots. Fairly well calibrated are the periods ≈4 Ga to ≈3 Ga BP (before present) and ≈0.8 Ga BP to the present. Crater counting and orbital chemistry (derived from remote sensing in spectral domains ranging from γ- and x-rays to the infrared) have identified mare basalt surfaces in the Oceanus Procellarum that appear to be nearly as young as 1 Ga. Samples returned from this area are needed for narrowing the gap of 2 Ga in the calibrated timescale. The lunar timescale is not only used for reconstructing lunar evolution, but it serves also as a standard for chronologies of the

Arts on prescription: a qualitative outcomes study.

Science.gov (United States)

Stickley, T; Eades, M

2013-08-01

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

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science; Volume 110; Issue 4. Evolution of the Bhandara-Balaghat granulite belt along the southern margin of the Sausar Mobile Belt of central India. H M Ramachandra Abhinaba Roy. Volume 110 Issue 4 December 2001 pp 351-368 ...

First simultaneous detection of terrestrial ionospheric molecular ions in the Earth's inner magnetosphere and at the Moon

Science.gov (United States)

Dandouras, I.; Poppe, A. R.; Fillingim, M. O.; Kistler, L. M.; Mouikis, C. G.; Rème, H.

2017-09-01

First coordinated observation of escaping heavy molecular ions in the Earth's inner magnetosphere and at the Moon. Quantifying the underlying escape mechanisms is important in order to understand the long-term (billion years scale) evolution of the atmospheric composition, and in particular the evolution of the N/O ratio, which is essential for habitability. Terrestrial heavy ions, transported to the Moon, suggest also that the Earth's atmosphere of billions of years ago may be preserved on the present-day lunar regolith.

Patterns of dose variability in radiation prescription of breast cancer

International Nuclear Information System (INIS)

Das, Indra J.; Chee-Wai, Cheng; Fein, Douglas A.; Fowble, Barbara

1995-01-01

Objective: Radiation dose distribution varies with breast size, beam energy, beam modifiers (wedge, bolus), and beam weights. A dose variation as low as ± 5% has been observed to change outcome of the radiation treatment. Various reports suggest that radiation dose >50 Gy and dose inhomogeneity >10% have unfavorable cosmesis. It is difficult to estimate treatment outcome and compare data in various protocols due to the variability of dose prescriptions. A retrospective analysis of the pattern of dose prescription and intercomparison of various protocols is presented for the treatment of breast cancer. Materials and Methods: In this study, five prescription points were chosen to represent the commonly used protocols for breast irradiation. All these points lie on a line of height, h, of the breast apex from the posterior non-divergent beam edge at half the chest-wall separation,s . The points are located at a distance 1.5 cm, chest wall-lung interface (2-3 cm), (h(3)), (h(2)), and at isocenter. One hundred consecutive patients treated with intact breast irradiation following excisional biopsy were selected. For analysis, treatment planning was carried out without lung correction with a 6 MV beam for all patients, even though some of the patients were treated with high energy beams. Dose distributions were optimized with proper wedges and beam weights to provide a symmetrical dose distribution on the central axis plane. A multivariate analysis of the different parameters, s,h , dose at the hot spot, and doses at various prescription points were carried out. The patients were divided into three groups based on the chest-wall separations: small ( 22.0 cm). The dose distributions related to various prescription points used in different protocols were analyzed for three groups of the patients. Results: The magnitudes of the hot spots varied from +5% to +27% among the patient population, were directly related to s, and appeared to be independent of h. The hot spots

The Sustainability of Habitability on Terrestrial Planets: Insights, Questions, and Needed Measurements from Mars for Understanding the Evolution of Earth-Like Worlds

Science.gov (United States)

Ehlmann, B. L.; Anderson, F. S.; Andrews-Hanna, J.; Catling, D. C.; Christensen, P. R.; Cohen, B. A.; Dressing, C. D.; Edwards, C. S.; Elkins-Tanton, L. T.; Farley, K. A.;

Towards Non-prescriptive Issues: a Teaching Framework for Selecting Marketing Dissertation Topics

OpenAIRE

Horan, Conor

2006-01-01

There is a significant absence in academic literature, textbooks and practical teaching tools for advising or guiding student learning, in a practical non-prescriptive manner, toward topic selection and development. Prescriptive or rational approaches, taken by many research methods textbooks, are not adequate or sufficient when teaching this important first stage in the research process. Non-prescriptive approaches describing manageable steps should be researched more to fill this pedagogic ...

Evaluation of antibiotic prescription in the Lebanese community: a pilot study

Directory of Open Access Journals (Sweden)

Nadine Saleh

2015-06-01

Full Text Available Background: Antibiotics are considered among the most commonly prescribed drug classes in developing countries. Inappropriate prescription of antibiotics is a major public health concern and is related to the development of antimicrobial resistance. Objective: This study aimed at assessing the appropriateness of antibiotic prescription by non-infectious disease physicians in a community setting in Lebanon. Methods: A pilot cross-sectional study was undertaken on community pharmacy patients presenting with antibiotic prescription. It was performed over a period of 4 months in different regions of Lebanon. Participants answered a questionnaire inquiring about socio-demographic characteristics, medical conditions, symptoms that required medical attention, the doctor's diagnosis, the prescribed antibiotic, and whether laboratory tests were ordered to identify the causative organism or not. Data were analyzed using SPSS 17. Results: We studied 270 patients (49.3% males and 50.7% females. This study showed that the most-prescribed antibiotics were the cephalosporins (82% and that almost half of the illnesses for which antibiotics were prescribed were respiratory tract infections (41%. The study also showed that the choice of the prescribed antibiotic was appropriate in 61.5% of the studied cases, while the prescribed dose and the duration of the treatment were inaccurate in 52 and 64% of the cases, respectively. In addition, fever seemed to be a factor that influenced the physician's prescriptions, since the choice of drug conformity to guidelines increased from 53.7% (1 day of fever to 88.9% (1 week of fever, and the dose prescription compliance to guidelines was higher (55.9% for patients suffering from fever compared to those with no fever (38.1%. Conclusion: This study showed a high prevalence of inappropriate antibiotic prescriptions in Lebanon. Therefore, actions should be taken to optimize antibiotic prescription.

Medical and Nonmedical Use of Prescription Opioids among High School Seniors in the United States

Science.gov (United States)

McCabe, Sean Esteban; West, Brady T.; Teter, Christian J.; Boyd, Carol J.

2012-01-01

Objective To determine the prevalence of medical and nonmedical use of prescription opioids among high school seniors in the United States, and to assess substance use behaviors based on medical and nonmedical use of prescription opioids. Design Nationally representative samples of high school seniors (modal age 18) were surveyed during the spring of their senior year via self-administered questionnaires. Setting Data were collected in public and private high schools. Participants The sample consisted of 7,374 students from three independent cohorts (2007-09). Main Outcome Measures Self-reports of medical and nonmedical use of prescription opioids and other substance use. Results An estimated 17.6% of high school seniors reported lifetime medical use of prescription opioids, while 12.9% reported nonmedical use of prescription opioids. Gender differences in the medical and nonmedical use were minimal, while racial/ethnic differences were extensive. Over 37% of nonmedical users reported intranasal administration of prescription opioids. An estimated 80% of nonmedical users with an earlier history of medical use had obtained prescription opioids from a prescription they had previously. The odds of substance use behaviors were greater among individuals who reported any history of nonmedical use of prescription opioids relative to those who reported medical use only. Conclusions Nearly one in every four high school seniors in the United States has ever had some exposure to prescription opioids either medically or nonmedically. The quantity of prescription opioids and number of refills prescribed to adolescents should be carefully considered and closely monitored to reduce subsequent nonmedical use of leftover medication. PMID:22566521

[Concordance between hospital prescriptions and recommendations in the treatment of mania].

Science.gov (United States)

Laforgue, Edouard-Jules; Bulteau, Samuel; Cholet, Jennyfer; Victorri-Vigneau, Caroline; Guitteny, Marie; Mauduit, Nicolas; Vanelle, Jean-Marie; Sauvaget, Anne

2017-06-01

There are differences between recommendations and practice in the pharmacological treatment of acute mania. The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice. We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments. Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge. Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Workaround identification as an instrument for work analysis and design: a case study on ePrescription.

Science.gov (United States)

Vassilakopoulou, Polyxeni; Tsagkas, Vassilis; Marmaras, Nicolas

2012-01-01

This paper investigates workarounds occurring while pharmacists use an electronic prescription (ePrescription) application. ePrescription enables physicians to send prescriptions electronically to pharmacies and was recently introduced in Greece as a solution for controlling the ever-increasing medication costs and improving patient safety. The research was carried out in two phases: (i) review of the relevant documentation, (ii) fieldwork (field observations and semi-structured interviews with the pharmacists) in three pharmacies. The workarounds identified fall into five categories and namely: (a) bypass of ePrescription application (i.e. ePrescription application is not used at all), (b) temporal nonconformity in the use of ePrescription application (i.e. usage of the application, but not at the formally specified time), (c) catachresis of ePrescription application (i.e. usage of the application, but not according to the intended way), (d) ePrescription application substitution by another electronic application, and (e) delegation of ePrescription application usage to non-authorized users. The outcome of the research can be used for the improvement of multiple work system elements such as the tools, the procedures, the organisational arrangements and the policies.

Investigating the Origin and Evolution of Venus with in Situ Mass Spectrometry

Science.gov (United States)

Trainer, M. G.; Mahaffy, P. R.; Brinckerhoff, W. B.; Johnson, N. M.; Glaze, L. S.

2016-01-01

The exploration of Venus continues to be a top priority of planetary science. The Planetary Decadal Survey goals for inner-planet exploration seek to discern the origin and diversity of terrestrial planets, understand how the evolution of terrestrial planets relates to the evolution of life, and explore the processes that control climate on Earth-like planets. These goals can only be realized through continued and extensive exploration of Venus, the most mysterious of the terrestrial planets, remarkably different from the Earth despite the gross similarities between these "twin planets". It is unknown if this apparent divergence was intrinsic, programmed during accretion from distinct nebular reservoirs, or a consequence of either measured or catastrophic processes during planetary evolution. Even if the atmosphere of Venus is a more "recent" development, its relationship to the resurfacing of the planet's enigmatic surface is not well understood. Resolving such uncertainties directly addresses the hypothesis of a more clement, possibly water-rich era in Venus' past as well as whether Earth could become more Venus-like in the future.

Ion distributions in the Earth's foreshock upstream from the bow shock

Science.gov (United States)

Fuselier, S. A.

1995-01-01

A variety of suprathermal and energetic ion distributions are found upstream from shocks. Some distributions, such as field-aligned beams, are generated directly at the shock either through reflection processes or through leakage from the hotter downstream region. Other distributions, such as intermediate distributions, evolve from these parent distributions through wave-particle interactions. This paper reviews our current understanding of the creation and evolution of suprathermal distributions at shocks. Examples of suprathermal ion distributions are taken from observations at the Earth's bow shock. Particular emphasis is placed on the creation of field-aligned beams and specularly reflected ion distributions and on the evolution of these distributions in the Earth's ion foreshock. However, the results from this heavily studied region are applicable to interplanetary shocks, bow shocks at other planets, and comets.

77 FR 74827 - Working Group on Access to Information on Prescription Drug Container Labels

Science.gov (United States)

2012-12-18

... on Prescription Drug Container Labels AGENCY: Architectural and Transportation Barriers Compliance... information on prescription drug container labels accessible to people who are blind or visually impaired. The... stakeholder working group to develop best practices for making information on prescription drug container...

Assessment of linezolid prescriptions in three French hospitals.

Science.gov (United States)

Dentan, C; Forestier, E; Roustit, M; Boisset, S; Chanoine, S; Epaulard, O; Pavese, P

2017-07-01

The use of linezolid to treat gram-positive cocci infections is increasing in France. Linezolid is approved in pneumonia and complicated skin and soft tissue infections. Overuse and misuse of linezolid can favor the emergence and spreading of linezolid-resistant strains. We aimed to assess the appropriateness of linezolid use in French hospitals. This is a multicenter, retrospective study conducted in three tertiary care hospitals. Appropriateness of linezolid indications and adequacy (composite score concerning dosage, route of administration and blood monitoring) were assessed. Over a three-month period, all prescriptions of linezolid were extracted and analyzed by two independent infectious disease experts. Among the 81 initial prescriptions that were evaluated, indication was appropriate in 48% of cases. Among those, 51% complied with international guidelines. Fifty-seven percent of the prescriptions were adequate regarding dosage, route of administration and blood monitoring. Overall, 23% of prescriptions combined both appropriateness and adequacy. The most frequent reasons for inappropriateness were the possibility of choosing narrower-spectrum antibiotics and the empirical use of linezolid in severe sepsis or septic shock. Initial treatment was the most frequently appropriate in bone and joint infection cases (p = 0.001). Our study shows that even if modalities of use were mostly correct, appropriateness of linezolid indications is low. Educational programs are mandatory to improve practices, as well as clinical studies to better assess the efficacy and safety of linezolid in clinical situations other than pneumonia or complicated skin and soft tissue infections.

Non-prescription medications: considerations for the dental practitioner.

Science.gov (United States)

Kingon, Angus

2012-04-01

The widespread availability of non-prescription medications has a significant potential impact on dental practice. Dentists are trained to provide scientifically-based advice on the appropriate use of medications, but it is not uncommon for patients to take matters into their own hands, especially if it is felt that the treatment provided is not solving a specific problem, or is insufficient. Well-meaning but often ill-informed family and friends frequently have an opinion as to what should be done. Not only may the suggested treatment not be effective, it may also be harmful. Over-the-counter medications can easily be obtained, and there is nothing to stop individuals exceeding recommended doses, and if this occurs, there could be adverse medical sequelae. Patient compliance in taking prescription medications is known to be problematic, and when combined with the ready availability of complementary medications, probiotics and illicit drugs, the risk of self-harm can be seen to be a distinct possibility. To compound the position, sometimes there seems to be, in a practical sense, little regulation on the advertising and marketing of non-prescription medications, which can leave consumers not only confused but potentially vulnerable. While complementary medicines may not have a significant role in dental practice in 2012, that may not always be the case as research continues, and reference is made to some aspects of ongoing work. Non-prescription medications are discussed, and some effects on oral health are considered.

A Planet for Goldilocks: The Search for Evidence of Life Beyond Earth

Science.gov (United States)

Batalha, Natalie M.

2018-01-01

A Planet for Goldilocks: The Search for Evidence of Life Beyond Earth "Not too hot, not too cold" begins the prescription for a world that's just right for life as we know it. Finding evidence of life beyond Earth is one of the primary goals of science agencies around the world thanks in large part to NASA's Kepler Mission which launched in 2009 with the objective of finding Goldilocks planets orbiting other stars like our Sun. Indeed, the space telescope opened our eyes to the terrestrial-sized planets that populate the galaxy as well as exotic worlds unlike anything that exists in the solar system. The mission ignited the search for life beyond earth via remote detection of atmospheric biosignatures on exoplanets. Most recently, our collective imagination was awakened by the discovery of Goldilocks worlds orbiting some of the nearest neighbors to the Sun, turning abstractions into destinations. Dr. Batalha will give an overview of the science legacy of the Kepler Mission and other key discoveries. She'll give a preview of what's to come by highlighting the missions soon to launch and those that are concepts taking shape on the drawing board.

Preliminary analysis on tectonic movement and uranium metallization in Kang-Dian the earth's axis

International Nuclear Information System (INIS)

Luo Yiyue; Wei Mingji; Ma Guangzhong

1998-01-01

On the basis of analyzing available data the authors expounds the regional geology, tectonic movement, as well as the relationship between geological evolution and uranium metallization in Kang-Dian the earth's axis and propose that the Jinning Period (960-1006 Ma) is the first metallogenic epoch of uranium in Kang-Dian the earth's axis

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science; Volume 114; Issue 3. Significance of transition between Talchir Formation and Karharbari Formation in Lower Gondwana basin evolution — A study in West Bokaro Coal basin, Jharkhand, India. H N Bhattacharya Abhijit Chakraborty Biplab Bhattacharya. Volume 114 Issue ...

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science; Volume 121; Issue 4 ... Monsoon sensitivity to aerosol direct radiative forcing in the community atmosphere model .... Influences of the boundary layer evolution on surface ozone variations at a .... and its comparison with global geopotential models and GPS-levelling data.

Penguin heat-retention structures evolved in a greenhouse Earth.

Science.gov (United States)

Thomas, Daniel B; Ksepka, Daniel T; Fordyce, R Ewan

2011-06-23

Penguins (Sphenisciformes) inhabit some of the most extreme environments on Earth. The 60+ Myr fossil record of penguins spans an interval that witnessed dramatic shifts in Cenozoic ocean temperatures and currents, indicating a long interplay between penguin evolution and environmental change. Perhaps the most celebrated example is the successful Late Cenozoic invasion of glacial environments by crown clade penguins. A major adaptation that allows penguins to forage in cold water is the humeral arterial plexus, a vascular counter-current heat exchanger (CCHE) that limits heat loss through the flipper. Fossil evidence reveals that the humeral plexus arose at least 49 Ma during a 'Greenhouse Earth' interval. The evolution of the CCHE is therefore unrelated to global cooling or development of polar ice sheets, but probably represents an adaptation to foraging in subsurface waters at temperate latitudes. As global climate cooled, the CCHE was key to invasion of thermally more demanding environments associated with Antarctic ice sheets.

The role of biology in planetary evolution: cyanobacterial primary production in low‐oxygen Proterozoic oceans

Science.gov (United States)

Bryant, Donald A.; Macalady, Jennifer L.

2016-01-01

Summary Understanding the role of biology in planetary evolution remains an outstanding challenge to geobiologists. Progress towards unravelling this puzzle for Earth is hindered by the scarcity of well‐preserved rocks from the Archean (4.0 to 2.5 Gyr ago) and Proterozoic (2.5 to 0.5 Gyr ago) Eons. In addition, the microscopic life that dominated Earth's biota for most of its history left a poor fossil record, consisting primarily of lithified microbial mats, rare microbial body fossils and membrane‐derived hydrocarbon molecules that are still challenging to interpret. However, it is clear from the sulfur isotope record and other geochemical proxies that the production of oxygen or oxidizing power radically changed Earth's surface and atmosphere during the Proterozoic Eon, pushing it away from the more reducing conditions prevalent during the Archean. In addition to ancient rocks, our reconstruction of Earth's redox evolution is informed by our knowledge of biogeochemical cycles catalysed by extant biota. The emergence of oxygenic photosynthesis in ancient cyanobacteria represents one of the most impressive microbial innovations in Earth's history, and oxygenic photosynthesis is the largest source of O 2 in the atmosphere today. Thus the study of microbial metabolisms and evolution provides an important link between extant biota and the clues from the geologic record. Here, we consider the physiology of cyanobacteria (the only microorganisms capable of oxygenic photosynthesis), their co‐occurrence with anoxygenic phototrophs in a variety of environments and their persistence in low‐oxygen environments, including in water columns as well as mats, throughout much of Earth's history. We examine insights gained from both the rock record and cyanobacteria presently living in early Earth analogue ecosystems and synthesize current knowledge of these ancient microbial mediators in planetary redox evolution. Our analysis supports the hypothesis that anoxygenic

The role of biology in planetary evolution: cyanobacterial primary production in low-oxygen Proterozoic oceans.

Science.gov (United States)

Hamilton, Trinity L; Bryant, Donald A; Macalady, Jennifer L

2016-02-01

Understanding the role of biology in planetary evolution remains an outstanding challenge to geobiologists. Progress towards unravelling this puzzle for Earth is hindered by the scarcity of well-preserved rocks from the Archean (4.0 to 2.5 Gyr ago) and Proterozoic (2.5 to 0.5 Gyr ago) Eons. In addition, the microscopic life that dominated Earth's biota for most of its history left a poor fossil record, consisting primarily of lithified microbial mats, rare microbial body fossils and membrane-derived hydrocarbon molecules that are still challenging to interpret. However, it is clear from the sulfur isotope record and other geochemical proxies that the production of oxygen or oxidizing power radically changed Earth's surface and atmosphere during the Proterozoic Eon, pushing it away from the more reducing conditions prevalent during the Archean. In addition to ancient rocks, our reconstruction of Earth's redox evolution is informed by our knowledge of biogeochemical cycles catalysed by extant biota. The emergence of oxygenic photosynthesis in ancient cyanobacteria represents one of the most impressive microbial innovations in Earth's history, and oxygenic photosynthesis is the largest source of O2 in the atmosphere today. Thus the study of microbial metabolisms and evolution provides an important link between extant biota and the clues from the geologic record. Here, we consider the physiology of cyanobacteria (the only microorganisms capable of oxygenic photosynthesis), their co-occurrence with anoxygenic phototrophs in a variety of environments and their persistence in low-oxygen environments, including in water columns as well as mats, throughout much of Earth's history. We examine insights gained from both the rock record and cyanobacteria presently living in early Earth analogue ecosystems and synthesize current knowledge of these ancient microbial mediators in planetary redox evolution. Our analysis supports the hypothesis that anoxygenic photosynthesis

Factors Associated With the Prophylactic Prescription of a Bowel Regimen to Prevent Opioid-Induced Constipation.

Science.gov (United States)

Chen, Nancy Y; Nguyen, Eugene; Schrager, Sheree M; Russell, Christopher J

2016-11-01

Identify factors associated with the prophylactic prescription of a bowel regimen with an inpatient opioid prescription. This was a retrospective cohort study from June 1, 2013, to October 31, 2014 of pediatric inpatients prescribed an oral or intravenous opioid on the general medical/surgical floors. We identified patients with or without a prophylactic prescription of a bowel regimen. We obtained patient demographics, prescriber training level and service and used multivariate logistic regression to analyze the factors associated with prophylactic bowel regimen and opioid prescription. Of the 6682 encounters that met study criteria, only 966 (14.5%) encounters had prophylactic prescriptions. Patient factors associated with prophylactic prescription include increasing age (per year; odds ratio [OR] = 1.06, 95% confidence interval [CI] 1.05-1.07) and sickle cell diagnosis (OR = 3.19, 95% CI 2.08-4.91). Medication factors associated with prophylactic prescription include a scheduled opioid prescription (OR = 1.75, 95% CI 1.46-2.1) and a prescription for oxycodone (OR = 3.59, 95% CI 2.57-5.00) or morphine (OR = 1.84, 95% CI 1.39-2.44), compared with acetaminophen-hydrocodone. Compared with medical providers, surgeons were less likely (OR = 0.43, 95% CI 0.35-0.53) and pain service providers were more likely to prescribe a prophylactic bowel regimen (OR = 4.12, 95% CI 3.13-5.43). More than 85% of inpatient opioid prescriptions did not receive a prophylactic bowel regimen. Future research should examine factors (eg, clinical decision support tools) to increase prophylactic prescription of bowel regimens with opioids for populations found to have lower rates. Copyright © 2016 by the American Academy of Pediatrics.

Posttraumatic Stress Symptoms and Nonmedical Prescription Drug Use Among College Students With Trauma Exposure.

Science.gov (United States)

Ham, Lindsay S; Wiersma-Mosley, Jacquelyn D; Feldner, Matthew T; Melkonian, Alexander J; Milner, Lauren A; Lewis, Sarah F

2016-01-01

Nonmedical prescription drug use, defined as using the drug without a prescription or in ways for which it is not prescribed, and traumatic event exposure are highly prevalent among college students. Despite evidence that posttraumatic stress symptoms could place college students at risk for nonmedical prescription drug problems, no studies have examined this relationship. This study was a preliminary examination of posttraumatic stress symptoms, lifetime nonmedical prescription drug use, hazardous use, and dependence symptoms among college students with trauma exposure. Participants were students attending a rural college in Virginia, recruited through psychology classes, flyers, LISTSERVs, and announcements at student events. All students who reported experiencing at least one traumatic event were included (N = 119); participants' mean age was 19.7 years (SD = 1.90), about half were women (n = 63, 53%), and most were Caucasian (n = 103, 87%). Nearly 60% of participants (n = 71) reported using nonmedical prescription drugs at least once during their lifetime and were more likely than those with no use to report hazardous alcohol use (p drugs. Regression analyses showed that posttraumatic stress symptom frequency was positively associated with hazardous nonmedical prescription drug use, after controlling for gender, depressive symptoms, and hazardous alcohol use (p stress symptom frequency was higher for those with any nonmedical prescription drug dependence symptoms (p drug use. Findings suggest that consideration of the types of behaviors and problems a college student is experiencing related to nonmedical prescription drug use may be more relevant to posttraumatic stress symptom frequency than dichotomous measures of nonmedical prescription drug use alone. Further, the association between the frequency of posttraumatic stress symptoms and both hazardous nonmedical prescription drug use and dependence symptoms among college students with a trauma history

Surveillance of broad-spectrum antibiotic prescription in Singaporean hospitals: a 5-year longitudinal study.

Directory of Open Access Journals (Sweden)

Yi-Xin Liew

Full Text Available BACKGROUND: Inappropriate prescription of antibiotics may contribute towards higher levels antimicrobial resistance. A key intervention for improving appropriate antibiotic prescription is surveillance of prescription. This paper presents the results of a longitudinal surveillance of broad-spectrum antibiotic prescription in 5 public-sector hospitals in Singapore from 2006 to 2010. METHODOLOGY/PRINCIPAL FINDINGS: Quarterly antibiotic prescription data were obtained and converted to defined daily doses (DDDs per 1,000 inpatient-days. The presence of significant trends in antibiotic prescription over time for both individual and combined hospitals was tested by regression analysis and corrected for autocorrelation between time-points. Excluding fluoroquinolones, there was a significant increase in prescription of all monitored antibiotics from an average of 233.12 defined daily doses (DDD/1,000 inpatient-days in 2006 to 254.38 DDD/1,000 inpatient-days in 2010 (Coefficient = 1.13, 95%CI: 0.16-2.09, p = 0.025. Increasing utilization of carbapenems, piperacillin/tazobactam, and Gram-positive agents were seen in the majority of the hospitals, while cephalosporins were less prescribed over time. The combined expenditure for 5 hospitals increased from USD9.9 million in 2006 to USD16.7 million in 2010. CONCLUSIONS/SIGNIFICANCE: The rate of prescription of broad-spectrum antibiotics in Singaporean hospitals is much higher compared to those of European hospitals. This may be due to high rates of antimicrobial resistance. The increase in expenditure on monitored antibiotics over the past 5 years outstripped the actual increase in DDD/1,000 inpatient-days of antibiotics prescribed. Longitudinal surveillance of antibiotic prescription on a hospital and countrywide level is important for detecting trends for formulating interventions or policies. Further research is needed to understand the causes for the various prescription trends and to act on these where

Reducing Prescriptions of Long-acting Benzodiazepine Drugs in Denmark

DEFF Research Database (Denmark)

Eriksen, Sophie Isabel; Bjerrum, Lars

2015-01-01

Prolonged consumption of benzodiazepine drugs (BZD) and benzodiazepine receptor agonists (zolpidem, zaleplon, zopiclone; altogether Z drugs) is related to potential physiological and psychological dependence along with other adverse effects. This study aimed to analyse the prescribing of long...... to the prescription. The observed reduction in BZD use was correlated to the introduction of new national guidelines on prescription of addictive drugs, but this study was not designed to detect a causal relationship. The prescribing of long-acting BZD decreased considerably more than the prescribing of short......-acting BZD (half-life >10 hr), compared to short-acting BZD in Denmark during a 10-year period. Descriptive analysis of total sales data from the Danish Register of Medicinal Product Statistics, to individuals in the primary healthcare sector, of all BZD and Z-drugs in the period of 2003-2013. Prescription...

The Australian Computational Earth Systems Simulator

Science.gov (United States)

Mora, P.; Muhlhaus, H.; Lister, G.; Dyskin, A.; Place, D.; Appelbe, B.; Nimmervoll, N.; Abramson, D.

2001-12-01

behaviour of earth systems. ACcESS represents a part of Australia's contribution to the APEC Cooperation for Earthquake Simulation (ACES) international initiative. Together with other national earth systems science initiatives including the Japanese Earth Simulator and US General Earthquake Model projects, ACcESS aims to provide a driver for scientific advancement and technological breakthroughs including: quantum leaps in understanding of earth evolution at global, crustal, regional and microscopic scales; new knowledge of the physics of crustal fault systems required to underpin the grand challenge of earthquake prediction; new understanding and predictive capabilities of geological processes such as tectonics and mineralisation.

Climatic Change and Human Evolution.

Science.gov (United States)

Garratt, John R.

1995-01-01

Traces the history of the Earth over four billion years, and shows how climate has had an important role to play in the evolution of humans. Posits that the world's rapidly growing human population and its increasing use of energy is the cause of present-day changes in the concentrations of greenhouse gases in the atmosphere. (Author/JRH)

Outpatient prescription practices in rural township health centers in Sichuan Province, China

Directory of Open Access Journals (Sweden)

Jiang Qian

2012-09-01

Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the

The availability of prescription-only analgesics purchased from the internet in the UK.

Science.gov (United States)

Raine, Connie; Webb, David J; Maxwell, Simon R J

2009-02-01

Increasing numbers of people are accessing medicines from the internet. This online market is poorly regulated and represents a potential threat to the health of patients and members of the public. Prescription-only analgesics, including controlled opioids, are readily available to the UK public through internet pharmacies that are easily identified by popular search engines. The majority of websites do not require the customer to possess a valid prescription for the drug. Less than half provide an online health screen to assess suitability for supply. The majority have no registered geographical location. Analgesic medicines are usually purchased at prices significantly above British National Formulary prices and are often supplied in large quantities. These findings are of particular relevance to pain-management specialists who are trying to improve the rational use of analgesic drugs. To explore the availability to the UK population of prescription-only analgesics from the internet. Websites were identified by using several keywords in the most popular internet search engines. From 2000 websites, details of 96 were entered into a database. Forty-six (48%) websites sold prescription analgesics, including seven opioids, two non-opioids and 18 nonsteroidal anti-inflammatory drugs. Thirty-five (76%) of these did not require the customer to possess a valid prescription. Prescription-only analgesics, including controlled opioids, are readily available from internet websites, often without a valid prescription.

Prevalence and predictors of antibiotic prescription errors in an emergency department, Central Saudi Arabia.

Science.gov (United States)

Alanazi, Menyfah Q; Al-Jeraisy, Majed I; Salam, Mahmoud

2015-01-01

Inappropriate antibiotic (ATB) prescriptions are a threat to patients, leading to adverse drug reactions, bacterial resistance, and subsequently, elevated hospital costs. Our aim was to evaluate ATB prescriptions in an emergency department of a tertiary care facility. A cross-sectional study was conducted by reviewing charts of patients complaining of infections. Patient characteristics (age, sex, weight, allergy, infection type) and prescription characteristics (class, dose, frequency, duration) were evaluated for appropriateness based on the AHFS Drug Information and the Drug Information Handbook. Descriptive and analytic statistics were applied. Sample with equal sex distribution constituted of 5,752 cases: adults (≥15 years) =61% and pediatrics (tract infections, 25% urinary tract infections (UTIs), and 20% others. Broad-spectrum coverage ATBs were prescribed for 76% of the cases. Before the prescription, 82% of pediatrics had their weight taken, while 18% had their weight estimated. Allergy checking was done in 8% only. Prevalence of inappropriate ATB prescriptions with at least one type of error was 46.2% (pediatrics =58% and adults =39%). Errors were in ATB selection (2%), dosage (22%), frequency (4%), and duration (29%). Dosage and duration errors were significantly predominant among pediatrics (Ppredictors of inappropriate prescriptions were associated with: 1) cephalosporin prescriptions (adults: Ppediatrics: Ppediatrics: P=0.039, adj OR =0.73) compared to respiratory tract infections; 3) obtaining weight for pediatrics before the prescription of ATB (Pinfections.

Pediatrician prescriptions for outdoor physical activity among children: A pilot study.

Science.gov (United States)

Christiana, Richard W; Battista, Rebecca A; James, Joy J; Bergman, Shawn M

2017-03-01

Research indicates that promoting time spent in the outdoors and outdoor physical activity increases children's daily physical activity and improves health. One method showing promise is doctor prescriptions for outdoor physical activity for children; however, no empirical evidence currently exists on prescriptions for children's outdoor physical activity. A pilot study was conducted at one pediatric practice in western North Carolina during 2015 to test the feasibility and potential effectiveness of conducting an outdoor physical activity prescription program for children aged 5-13 years. Three pediatricians wrote prescriptions for children ( n  = 38), discussed benefits of outdoor physical activity, and provided information packets to parents on nearby places for physical activity. Parents of patients of five pediatricians served as control ( n  = 32). Prior to seeing a pediatrician, parents completed a baseline survey that asked height and weight, assessed their views of children's physical activity, and their personal and child's physical activity/sedentary behaviors. A nurse measured children's height and weight. Parents were emailed one-month and three-month follow-up surveys that asked the questions listed above. Changes in children's physical activity, outdoor physical activity, time spent in the outdoors, and sedentary activities were not significant between intervention and control groups. About half of parents (49%) viewed prescriptions as beneficial for their children and most used the intervention materials at home (70%). A larger study is needed to assess whether prescriptions increase children's physical activity. A critical examination of the intervention, pilot study design, and suggestions for a larger future study are provided.

Pediatrician prescriptions for outdoor physical activity among children: A pilot study

Directory of Open Access Journals (Sweden)

Richard W. Christiana

2017-03-01

Full Text Available Research indicates that promoting time spent in the outdoors and outdoor physical activity increases children's daily physical activity and improves health. One method showing promise is doctor prescriptions for outdoor physical activity for children; however, no empirical evidence currently exists on prescriptions for children's outdoor physical activity. A pilot study was conducted at one pediatric practice in western North Carolina during 2015 to test the feasibility and potential effectiveness of conducting an outdoor physical activity prescription program for children aged 5–13 years. Three pediatricians wrote prescriptions for children (n = 38, discussed benefits of outdoor physical activity, and provided information packets to parents on nearby places for physical activity. Parents of patients of five pediatricians served as control (n = 32. Prior to seeing a pediatrician, parents completed a baseline survey that asked height and weight, assessed their views of children's physical activity, and their personal and child's physical activity/sedentary behaviors. A nurse measured children's height and weight. Parents were emailed one-month and three-month follow-up surveys that asked the questions listed above. Changes in children's physical activity, outdoor physical activity, time spent in the outdoors, and sedentary activities were not significant between intervention and control groups. About half of parents (49% viewed prescriptions as beneficial for their children and most used the intervention materials at home (70%. A larger study is needed to assess whether prescriptions increase children's physical activity. A critical examination of the intervention, pilot study design, and suggestions for a larger future study are provided.

Prescription Program Provides Significant Savings

Science.gov (United States)

Rowan, James M.

2010-01-01

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

The origin of secondary heavy rare earth element enrichment in carbonatites: Constraints from the evolution of the Huanglongpu district, China

Science.gov (United States)

Smith, M.; Kynicky, J.; Xu, Cheng; Song, Wenlei; Spratt, J.; Jeffries, T.; Brtnicky, M.; Kopriva, A.; Cangelosi, D.

2018-05-01

The silico‑carbonatite dykes of the Huanglongpu area, Lesser Qinling, China, are unusual in that they are quartz-bearing, Mo-mineralised and enriched in the heavy rare earth elements (HREE) relative to typical carbonatites. The textures of REE minerals indicate crystallisation of monazite-(Ce), bastnäsite-(Ce), parisite-(Ce) and aeschynite-(Ce) as magmatic phases. Burbankite was also potentially an early crystallising phase. Monazite-(Ce) was subsequently altered to produce a second generation of apatite, which was in turn replaced and overgrown by britholite-(Ce), accompanied by the formation of allanite-(Ce). Bastnäsite and parisite where replaced by synchysite-(Ce) and röntgenite-(Ce). Aeschynite-(Ce) was altered to uranopyrochlore and then pyrochlore with uraninite inclusions. The mineralogical evolution reflects the evolution from magmatic carbonatite, to more silica-rich conditions during early hydrothermal processes, to fully hydrothermal conditions accompanied by the formation of sulphate minerals. Each alteration stage resulted in the preferential leaching of the LREE and enrichment in the HREE. Mass balance considerations indicate hydrothermal fluids must have contributed HREE to the mineralisation. The evolution of the fluorcarbonate mineral assemblage requires an increase in aCa2+ and aCO32- in the metasomatic fluid (where a is activity), and breakdown of HREE-enriched calcite may have been the HREE source. Leaching in the presence of strong, LREE-selective ligands (Cl-) may account for the depletion in late stage minerals in the LREE, but cannot account for subsequent preferential HREE addition. Fluid inclusion data indicate the presence of sulphate-rich brines during alteration, and hence sulphate complexation may have been important for preferential HREE transport. Alongside HREE-enriched magmatic sources, and enrichment during magmatic processes, late stage alteration with non-LREE-selective ligands may be critical in forming HREE

Rare gas systematics: Formation of the atmosphere, evolution and structure of the Earth's mantle

International Nuclear Information System (INIS)

Allegre, C.J.; Staudacher, T.; Sarda, P.; Paris-6 Univ., 75; Paris-7 Univ., 75

1987-01-01

To explain the rare gas content and isotopic composition measured in modern terrestrial materials we explore in this paper an Earth model based on four reservoirs: atmosphere, continental crust, upper mantle and lower mantle. This exploration employs three tools: mass balance equations, the concept of mean age of outgassing and the systematic use of all of the rare gases involving both absolute amount and isotopic composition. The results obtained are as follows: half of the Earth's mantle is 99% outgassed. Outgassing occurred in an early very intense stage within the first 50 Ma of Earth history and a slow continuous stage which continues to the present day. The mean age of the atmosphere is 4.4 Ga. Our model with four main reservoirs explains quantitatively both isotopic and chemical ratios, assuming that He migrates from the lower to the upper mantle whereas the heavy rare gases did not. Noble gas fluxes for He, Ar and Xe from different reservoirs have been estimated. The results constrain the K content in the earth to 278 ppm. Several geodynamic consequences are discussed. (orig.)

Journal of Earth System Science | Indian Academy of Sciences

Indian Academy of Sciences (India)

Home; Journals; Journal of Earth System Science; Volume 125; Issue 8. Formation and evolution of yardangs activated by Late Pleistocene tectonic movement in Dunhuang, Gansu Province of China. Yanjie Wang Fadong Wu Xujiao Zhang Peng Zeng Pengfei Ma Yuping Song Hao Chu. Volume 125 Issue 8 December ...

Earth's inner core: Innermost inner core or hemispherical variations?

NARCIS (Netherlands)

Lythgoe, K. H.; Deuss, A.|info:eu-repo/dai/nl/412396610; Rudge, J. F.; Neufeld, J. A.

2014-01-01

The structure of Earth's deep inner core has important implications for core evolution, since it is thought to be related to the early stages of core formation. Previous studies have suggested that there exists an innermost inner core with distinct anisotropy relative to the rest of the inner core.

Dynamic Processes of Cross-Tail Current in the Near-Earth Magnetotail

International Nuclear Information System (INIS)

Xing-Qiang, Lu; Zhi-Wei, Ma

2009-01-01

Current dynamic processes in realistic magnetotail geometry are studied by Hall magnetohydrodynamic (MHD) simulations under various driven conditions and Hall effects. Associated with the external driving force, a thin current sheet with a broad extent is built up in the near-Earth magnetotail. The time evolution for the formation of the current sheet comprises two phases: slow growth and a fast impulsive phase before the near-Earth disruption of the current sheet resulting from the fast magnetic reconnection. The simulation results indicate that as the external driving force increases, the site and the tailward speed of the near-Earth current disruption region are closer to the Earth and faster, respectively. Whether the near-Earth disruption of the current sheet takes place or not is mainly controlled by Hall effects. It is found that there is no sudden disruption of the current sheet in the near-Earth region if the ion inertial length is below d i = 0.04. (geophysics, astronomy, and astrophysics)

Employing the therapeutic operating characteristic (TOC) graph for individualised dose prescription.

Science.gov (United States)

Hoffmann, Aswin L; Huizenga, Henk; Kaanders, Johannes H A M

2013-03-07

In current practice, patients scheduled for radiotherapy are treated according to 'rigid' protocols with predefined dose prescriptions that do not consider risk-taking preferences of individuals. The therapeutic operating characteristic (TOC) graph is applied as a decision-aid to assess the trade-off between treatment benefit and morbidity to facilitate dose prescription customisation. Historical dose-response data from prostate cancer patient cohorts treated with 3D-conformal radiotherapy is used to construct TOC graphs. Next, intensity-modulated (IMRT) plans are generated by optimisation based on dosimetric criteria and dose-response relationships. TOC graphs are constructed for dose-scaling of the optimised IMRT plan and individualised dose prescription. The area under the TOC curve (AUC) is estimated to measure the therapeutic power of these plans. On a continuous scale, the TOC graph directly visualises treatment benefit and morbidity risk of physicians' or patients' choices for dose (de-)escalation. The trade-off between these probabilities facilitates the selection of an individualised dose prescription. TOC graphs show broader therapeutic window and higher AUCs with increasing target dose heterogeneity. The TOC graph gives patients and physicians access to a decision-aid and read-out of the trade-off between treatment benefit and morbidity risks for individualised dose prescription customisation over a continuous range of dose levels.

Employing the therapeutic operating characteristic (TOC) graph for individualised dose prescription

International Nuclear Information System (INIS)

Hoffmann, Aswin L; Huizenga, Henk; Kaanders, Johannes HAM

2013-01-01

In current practice, patients scheduled for radiotherapy are treated according to ‘rigid’ protocols with predefined dose prescriptions that do not consider risk-taking preferences of individuals. The therapeutic operating characteristic (TOC) graph is applied as a decision-aid to assess the trade-off between treatment benefit and morbidity to facilitate dose prescription customisation. Historical dose-response data from prostate cancer patient cohorts treated with 3D-conformal radiotherapy is used to construct TOC graphs. Next, intensity-modulated (IMRT) plans are generated by optimisation based on dosimetric criteria and dose-response relationships. TOC graphs are constructed for dose-scaling of the optimised IMRT plan and individualised dose prescription. The area under the TOC curve (AUC) is estimated to measure the therapeutic power of these plans. On a continuous scale, the TOC graph directly visualises treatment benefit and morbidity risk of physicians’ or patients’ choices for dose (de-)escalation. The trade-off between these probabilities facilitates the selection of an individualised dose prescription. TOC graphs show broader therapeutic window and higher AUCs with increasing target dose heterogeneity. The TOC graph gives patients and physicians access to a decision-aid and read-out of the trade-off between treatment benefit and morbidity risks for individualised dose prescription customisation over a continuous range of dose levels

[Physiotherapy and ergotherapy are indispensable. Concrete prescription of remedies - without recourse].

Science.gov (United States)

Engel, J-M

2012-07-01

Physical therapy and occupational therapy are essential for the treatment of inflammatory rheumatic diseases equal in rank to any drug therapy. They have enough evidence and are part of all current guidelines even if mostly not specified. In the German social security system the doctor prescribing physical therapy or occupational therapy has to act according to the different rules and forms as described in the current "Heilmittel Richtlinie" (Remedy directive) effective since July 2011. The multiple formal conditions and requirements of prescriptions are described in detail. Of special interest is that the global diagnosis of rheumatoid arthritis can no longer be used as the reason or justification for the individual prescription but detailed sub-diagnoses, regarding the essential ICF domains of structural damage, functional impairment, activity limitation and participation restriction as well as individual context factors are necessary. Of special interest is the fact that the prescribing doctor is no longer responsible for the formal correctness of prescriptions but the performing therapist, who will not be reimbursed if the prescription shows even minor formal errors. Another important improvement is the newly introduced long-term prescription of physical and occupational therapy. This facilitates the application of these therapies in the multimodal treatment regimen of rheumatic diseases.

Emergency department visits by pediatric patients for poisoning by prescription opioids.

Science.gov (United States)

Tadros, Allison; Layman, Shelley M; Davis, Stephen M; Bozeman, Rachel; Davidov, Danielle M

2016-09-01

Prescription medication abuse is an increasingly recognized problem in the United States. As more opioids are being prescribed and abused by adults, there is an increased risk of both accidental and intentional exposure to children and adolescents. The impact of pediatric exposures to prescription pain pills has not been well studied. We sought to evaluate emergency department (ED) visits for poisoning by prescription opioids in pediatric patients. This retrospective study looked at clinical and demographic data from the Nationwide Emergency Department Sample (NEDS) from 2006 to 2012. There were 21,928 pediatric ED visits for prescription opioid poisonings and more than half were unintentional. There was a bimodal age distribution of patients, with slightly more than half occurring in females. The majority of patients were discharged from the ED. More visits in the younger age group (0-5 years) were unintentional, while the majority of visits in the adolescent age group (15-17 years) were intentional. Mean charge per discharge was $1,840 and $14,235 for admissions and surmounted to over $81 million in total charges. Poisonings by prescription opioids largely impact both young children and adolescents. These findings can be used to help target this population for future preventive efforts.

The Earth's heterogeneous mantle a geophysical, geodynamical, and geochemical perspective

CERN Document Server

Khan, Amir

2015-01-01

This book highlights and discusses recent developments that have contributed to an improved understanding of observed mantle heterogeneities and their relation to the thermo-chemical state of Earth's mantle, which ultimately holds the key to unlocking the secrets of the evolution of our planet. This series of topical reviews and original contributions address 4 themes. Theme 1 covers topics in geophysics, including global and regional seismic tomography, electrical conductivity and seismic imaging of mantle discontinuities and heterogeneities in the upper mantle, transition zone and lower mantle. Theme 2 addresses geochemical views of the mantle including lithospheric evolution from analysis of mantle xenoliths, composition of the deep Earth and the effect of water on subduction-zone processes. Theme 3 discusses geodynamical perspectives on the global thermo-chemical structure of the deep mantle. Theme 4 covers application of mineral physics data and phase equilibrium computations to infer the regional-scale ...

The Effect of Opioid Prescribing Guidelines on Prescriptions by Emergency Physicians in Ohio.

Science.gov (United States)

Weiner, Scott G; Baker, Olesya; Poon, Sabrina J; Rodgers, Ann F; Garner, Chad; Nelson, Lewis S; Schuur, Jeremiah D

2017-12-01

The objective of our study is to evaluate the association between Ohio's April 2012 emergency physician guidelines aimed at reducing inappropriate opioid prescribing and the number and type of opioid prescriptions dispensed by emergency physicians. We used Ohio's prescription drug monitoring program data from January 1, 2010, to December 31, 2014, and included the 5 most commonly prescribed opioids (hydrocodone, oxycodone, tramadol, codeine, and hydromorphone). The primary outcome was the monthly statewide prescription total of opioids written by emergency physicians in Ohio. We used an interrupted time series analysis to compare pre- and postguideline level and trend in number of opioid prescriptions dispensed by emergency physicians per month, number of prescriptions stratified by 5 commonly prescribed opioids, and number of prescriptions for greater than 3 days' supply of opioids. Beginning in January 2010, the number of prescriptions dispensed by all emergency physicians in Ohio decreased by 0.3% per month (95% confidence interval [CI] -0.49% to -0.15%). The implementation of the guidelines in April 2012 was associated with a 12% reduction (95% CI -17.7% to -6.3%) in the level of statewide total prescriptions per month and an additional decline of 0.9% (95% CI -1.1% to -0.7%) in trend relative to the preguideline trend. The estimated effect of the guidelines on total monthly prescriptions greater than a 3-day supply was an 11.2% reduction in level (95% CI -18.8% to -3.6%) and an additional 0.9% (95% CI -1.3% to -0.5%) decline in trend per month after the guidelines. Guidelines were also associated with a reduction in prescribing for each of the 5 individual opioids, with various effect. In Ohio, emergency physician opioid prescribing guidelines were associated with a decrease in the quantity of opioid prescriptions written by emergency physicians. Although introduction of the guidelines occurred in parallel with other opioid-related interventions, our

[Summary of Hui prescriptions for treating cough].

Science.gov (United States)

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

2015-02-01

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

Evaluating the Impact of Prescription Fill Rates on Risk Stratification Model Performance.

Science.gov (United States)

Chang, Hsien-Yen; Richards, Thomas M; Shermock, Kenneth M; Elder Dalpoas, Stacy; J Kan, Hong; Alexander, G Caleb; Weiner, Jonathan P; Kharrazi, Hadi

2017-12-01

Risk adjustment models are traditionally derived from administrative claims. Prescription fill rates-extracted by comparing electronic health record prescriptions and pharmacy claims fills-represent a novel measure of medication adherence and may improve the performance of risk adjustment models. We evaluated the impact of prescription fill rates on claims-based risk adjustment models in predicting both concurrent and prospective costs and utilization. We conducted a retrospective cohort study of 43,097 primary care patients from HealthPartners network between 2011 and 2012. Diagnosis and/or pharmacy claims of 2011 were used to build 3 base models using the Johns Hopkins ACG system, in addition to demographics. Model performances were compared before and after adding 3 types of prescription fill rates: primary 0-7 days, primary 0-30 days, and overall. Overall fill rates utilized all ordered prescriptions from electronic health record while primary fill rates excluded refill orders. The overall, primary 0-7, and 0-30 days fill rates were 72.30%, 59.82%, and 67.33%. The fill rates were similar between sexes but varied across different medication classifications, whereas the youngest had the highest rate. Adding fill rates modestly improved the performance of all models in explaining medical costs (improving concurrent R by 1.15% to 2.07%), followed by total costs (0.58% to 1.43%), and pharmacy costs (0.07% to 0.65%). The impact was greater for concurrent costs compared with prospective costs. Base models without diagnosis information showed the highest improvement using prescription fill rates. Prescription fill rates can modestly enhance claims-based risk prediction models; however, population-level improvements in predicting utilization are limited.

The prescription talk – an approach to teach patient-physician conversation about drug prescription to medical students

Directory of Open Access Journals (Sweden)

Hauser, Katarina

2017-05-01

Full Text Available Background: Medication communication from physicians to patients often is poor, by this among others enhancing the risk of non-adherence. In this context, a neglect regarding the prescription talk has been complained.Aim of the project: In a newly developed elective medical students work on physician-patient conversations dealing with drug prescription. Essential aspects related to an effective and safe drug treatment are combined with steps of shared decision-making. Together with a tutor, students develop a (model conversation guide that might be tailored according to individual needs and views.Description/Methods: In a one-week course 3rd-5th year medical students treat a paper case according to problem-based learning. This is accompanied by a one-hour lecture and literature provided on an online learning platform (ILIAS. During a workshop, aspects of drug treatment and patient participation are integrated into a guide for a prescription talk. At the end of the week the students are invited to apply the (if need be individualized guide in a simulated physician-patient communication with an actor. The conversation is evaluated using a checklist based upon the (model conversation guide.Results: Informal and formalized feedback indicate high acceptance and satisfaction of participants with this elective. The checklist turned out to be of acceptable to good reliability with mostly selective items. Portfolio entries and written evaluation suggest that participants’ positions and attitudes are influenced.

Community pharmacists' prescription intervention practices--exploring variations in practice in Norwegian pharmacies.

Science.gov (United States)

Mandt, Ingunn; Horn, Anne Marie; Ekedahl, Anders; Granas, Anne Gerd

2010-03-01

Evidence suggests that prescription intervention frequencies have been found to vary as much as 10-fold among Norwegian pharmacies and among pharmacists within the same pharmacy. To explore community pharmacists' perceptions of how their prescription intervention practices were influenced by their working environment, their technological resources, the physical and social structures of the pharmacies, their relations with colleagues, and to the individual pharmacist's professional skills. Two focus groups consisting of 14 community pharmacists in total, from urban and rural areas in Norway, discussed their working procedures and professional judgments related to prescription interventions. Organizational theories were used as theoretical and analytical frameworks in the study. A framework based on Leavitt's organizational model was to structure our interview guide. The study units were the statements of the individual pharmacists. Recurrent themes were identified and condensed. Two processes describing variations in the dispensing workflow including prescription interventions were derived--an active dispensing process extracting information about the patient's medication from several sources and a fast dispensing process focusing mainly on the information available on the prescription. Both workflow processes were used in the same pharmacies and by the same pharmacist but on different occasions. A pharmacy layout allowing interactions between pharmacist and patients and a convenient organization of technology, layout, pharmacist-patient and pharmacist-coworker transactions at the workplace was essential for detecting and solving prescription problems. Pharmacists limited their contact with general practitioners when they considered the problem a formality and/or when they knew the answers themselves. The combined use of dispensing software and the Internet was a driving force toward more independent and cognitively advanced prescription interventions