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Sample records for non-prescription syringe sales

  1. Predicting pharmacy syringe sales to people who inject drugs: Policy, practice and perceptions.

    Science.gov (United States)

    Meyerson, Beth E; Davis, Alissa; Agley, Jon D; Shannon, David J; Lawrence, Carrie A; Ryder, Priscilla T; Ritchie, Karleen; Gassman, Ruth

    2018-06-01

    Pharmacies have much to contribute to the health of people who inject drugs (PWID) and to community efforts in HIV and hepatitis C (HCV) prevention through syringe access. However, little is known about what predicts pharmacy syringe sales without a prescription. To identify factors predicting pharmacy syringes sales to PWID. A hybrid staggered online survey of 298 Indiana community pharmacists occurred from July-September 2016 measuring pharmacy policy, practice, and pharmacist perceptions about syringe sales to PWID. Separate bivariate logistical regressions were followed by multivariable logistic regression to predict pharmacy syringe sales and pharmacist comfort dispensing syringes to PWID. Half (50.5%) of Indiana pharmacies sold syringes without a prescription to PWID. Pharmacy syringe sales was strongly associated with pharmacist supportive beliefs about syringe access by PWID and their comfort level selling syringes to PWID. Notably, pharmacies located in communities with high rates of opioid overdose mortality were 56% less likely to sell syringes without a prescription than those in communities with lower rates. Pharmacist comfort dispensing syringes was associated with being male, working at a pharmacy that sold syringes to PWID and one that stocked naloxone, having been asked about syringe access by medical providers, and agreement that PWID should be able to buy syringes without a prescription. As communities with high rates of opioid overdose mortality were less likely to have pharmacies that dispensed syringes to PWID, a concerted effort with these communities and their pharmacies should be made to understand opportunities to increase syringe access. Future studies should explore nuances between theoretical support for syringe access by PWID without a prescription and actual dispensing behaviors. Addressing potential policy conflicts and offering continuing education on non-prescription syringe distribution for pharmacists may improve comfort

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

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

    2014-05-01

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

  3. Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.

    Science.gov (United States)

    Stopka, Thomas J; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C

    To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions. Cross-sectional study. Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes. Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales. More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350

  4. Not sold here: limited access to legally available syringes at pharmacies in Tijuana, Mexico.

    Science.gov (United States)

    Pollini, Robin A; Rosen, Perth C; Gallardo, Manuel; Robles, Brenda; Brouwer, Kimberly C; Macalino, Grace E; Lozada, Remedios

    2011-05-24

    Sterile syringe access is a critical component of HIV prevention programs. Although retail pharmacies provide convenient outlets for syringe access, injection drug users (IDUs) may encounter barriers to syringe purchase even where purchase without a prescription is legal. We sought to obtain an objective measure of syringe access in Tijuana, Mexico, where IDUs report being denied or overcharged for syringes at pharmacies. Trained "mystery shoppers" attempted to buy a 1 cc insulin syringe according to a predetermined script at all retail pharmacies in three Tijuana neighborhoods. The same pharmacies were surveyed by telephone regarding their syringe sales policies. Data on purchase attempts were analyzed using basic statistics to obtain an objective measure of syringe access and compared with data on stated sales policies to ascertain consistency. Only 46 (28.4%) of 162 syringe purchase attempts were successful. Leading reasons for unsuccessful attempts were being told that the pharmacy didn't sell syringes (35.3%), there were no syringes in stock (31.0%), or a prescription was required (20.7%). Of 136 pharmacies also surveyed by telephone, a majority (88.2%) reported selling syringes but only one-third (32.5%) had a successful mystery shopper purchase; the majority of unsuccessful purchases were attributed to being told the pharmacy didn't sell syringes. There was similar discordance regarding prescription policies: 74 pharmacies said in the telephone survey that they did not require a prescription for syringes, yet 10 of these pharmacies asked the mystery shopper for a prescription. IDUs in Tijuana have limited access to syringes through retail pharmacies and policies and practices regarding syringe sales are inconsistent. Reasons for these restrictive and inconsistent practices must be identified and addressed to expand syringe access, reduce syringe sharing and prevent HIV transmission.

  5. Community Impact of Pharmacy-Randomized Intervention to Improve Access to Syringes and Services for Injection Drug Users

    Science.gov (United States)

    Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.

    2014-01-01

    Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…

  6. 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.

  7. Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales.

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    Costenbader, Elizabeth C; Zule, William A; Coomes, Curtis C

    2010-09-01

    Injecting drug users (IDUs) are at increased risk of acquiring and transmitting HIV and other bloodborne pathogens through the multi-person use of syringes. Although research has shown that increased access to syringes through syringe exchange programs (SEPs) is an effective strategy to reduce risky injection practices many areas of the United States still do not have SEPs. In the absence of SEPs, legislation allowing pharmacies over-the-counter sales of syringes has also been shown to reduce syringe sharing. The success of pharmacy sales however is limited by other legal stipulations, such as drug paraphernalia laws, which in turn may contribute to fear among IDUs about being caught purchasing and carrying syringes. Between 2003 and 2006, 851 out-of-treatment IDUs were recruited using street outreach in the Raleigh-Durham (North Carolina) area. Data were collected using audio-computer assisted interview (ACASI) technology. Multiple logistic regression analyses were performed to assess factors associated with purchasing syringes from pharmacies. In our study sample, African-American IDUs were one-fifth as likely as white IDUs to report pharmacies as their primary source of syringes. Given the absence of syringe exchange programs and the relatively high prevalence of HCV and HIV among IDUs in the Raleigh-Durham area, the limited use of pharmacies as a source of syringes among African-American IDUs in this study sample is problematic. The study findings support the need for effective multilevel interventions to increase access to clean needles in this population, as well as for policy interventions, such as legalization of SEPs and elimination of penalties for carrying syringes, to reduce harm and eliminate the health threats posed by receptive syringe sharing. Copyright 2010 Elsevier B.V. All rights reserved.

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

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    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.

  9. General sale of non-prescription medicinal products

    DEFF Research Database (Denmark)

    Lind, Johanna Lena Maria; Schafheutle, Ellen; Hägg, Annika Nordén

    2016-01-01

    BACKGROUND: The number of non-prescription medicines (NPMs) available for self-medication is increasing within the European Union (EU). This can enhance the autonomy of individuals but is also connected with risks. Under an existing EU Directive, Sweden has only recently deregulated and made NPMs...... market. There is a difference in the balance between confidence and control, as well as availability and safety when it comes to NPMs in non-pharmacy settings that needs to be further discussed....

  10. Twitter-Based Detection of Illegal Online Sale of Prescription Opioid.

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    Mackey, Tim K; Kalyanam, Janani; Katsuki, Takeo; Lanckriet, Gert

    2017-12-01

    To deploy a methodology accurately identifying tweets marketing the illegal online sale of controlled substances. We first collected tweets from the Twitter public application program interface stream filtered for prescription opioid keywords. We then used unsupervised machine learning (specifically, topic modeling) to identify topics associated with illegal online marketing and sales. Finally, we conducted Web forensic analyses to characterize different types of online vendors. We analyzed 619 937 tweets containing the keywords codeine, Percocet, fentanyl, Vicodin, Oxycontin, oxycodone, and hydrocodone over a 5-month period from June to November 2015. A total of 1778 tweets (marketing the sale of controlled substances online; 90% had imbedded hyperlinks, but only 46 were "live" at the time of the evaluation. Seven distinct URLs linked to Web sites marketing or illegally selling controlled substances online. Our methodology can identify illegal online sale of prescription opioids from large volumes of tweets. Our results indicate that controlled substances are trafficked online via different strategies and vendors. Public Health Implications. Our methodology can be used to identify illegal online sellers in criminal violation of the Ryan Haight Online Pharmacy Consumer Protection Act.

  11. Multiple access to sterile syringes for injection drug users: vending machines, needle exchange programs and legal pharmacy sales in Marseille, France.

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    Moatti, J P; Vlahov, D; Feroni, I; Perrin, V; Obadia, Y

    2001-03-01

    In Marseille, southeastern France, HIV prevention programs for injection drug users (IDUs) simultaneously include access to sterile syringes through needle exchange programs (NEPs), legal pharmacy sales and, since 1996, vending machines that mechanically exchange new syringes for used ones. The purpose of this study was to compare the characteristics of IDUs according to the site where they last obtained new syringes. During 3 days in September 1997, all IDUs who obtained syringes from 32 pharmacies, four NEPs and three vending machines were offered the opportunity to complete a self-administered questionnaire on demographics, drug use characteristics and program utilization. Of 485 individuals approached, the number who completed the questionnaire was 141 in pharmacies, 114 in NEPs and 88 at vending machines (response rate = 70.7%). Compared to NEP users, vending machine users were younger and less likely to be enrolled in a methadone program or to report being HIV infected, but more likely to misuse buprenorphine. They also had lower financial resources and were less likely to be heroin injectors than both pharmacy and NEP users. Our results suggest that vending machines attract a very different group of IDUs than NEPs, and that both programs are useful adjuncts to legal pharmacy sales for covering the needs of IDUs for sterile syringes in a single city. Assessment of the effectiveness and cost-effectiveness of combining such programs for the prevention of HIV and other infectious diseases among IDUs requires further comparative research. Copyright 2001 S. Karger AG, Basel

  12. Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

    Science.gov (United States)

    Crawford, Natalie D; Amesty, Silvia; Rivera, Alexis V; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M

    2013-09-01

    Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

  13. Status of Emergency Contraceptives in Europe One Year after the European Medicines Agency's Recommendation to Switch Ulipristal Acetate to Non-Prescription Status.

    Science.gov (United States)

    Italia, Salvatore; Brand, Helmut

    2016-01-01

    In November 2014, the European Medicines Agency (EMA) recommended switching the emergency contraceptive (EMC) ulipristal acetate to non-prescription status. This study's objective is to assess the current legal status of the two EMCs ulipristal acetate and levonorgestrel in Europe and to report on the development of sales figures for EMCs since they were made freely available. Health authorities were contacted in autumn 2015 and asked about the current status of EMCs and whether the sales figures had changed after a switch to non-prescription status. Additionally, data on consumption were collected in 18 German community pharmacies. As of November 2015, most countries in the European Union (EU) have followed the EMA recommendation. Hungary kept the prescription-only status. In Malta, EMC drugs are not authorized. Germany and Croatia switched levonorgestrel to non-prescription status as well. Of the EU candidate and European Free Trade Association countries, ulipristal acetate is available without prescription in Norway and Bosnia and Herzegovina only. Several countries reported an increase in EMC sales since the switch. An EMA recommendation can strongly contribute to the harmonization of a drug's legal status in the EU. In most European countries, ulipristal acetate and/or levonorgestrel are now freely available. © 2016 The Author(s) Published by S. Karger AG, Basel.

  14. Drug companies monitor prescriptions and sales to fine-tune their marketing strategies.

    Science.gov (United States)

    2010-06-01

    Market research companies analyse drug prescriptions and sales in community and hospital pharmacies, thus enabling drug companies to refine their marketing strategies. Some information of interest to drug companies is provided directly by healthcare professionals, sometimes unwittingly, and sometimes in return for small "favours".

  15. 48 CFR 245.7307 - Non-competitive sales.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Non-competitive sales. 245..., DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Sale of Surplus Contractor Inventory 245.7307 Non-competitive sales. ...

  16. The association of syringe type and syringe cleaning with HCV infection among IDUs in Budapest, Hungary

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    Gyarmathy, V. Anna; Neaigus, Alan; Mitchell, Mary M.; Ujhelyi, Eszter

    2008-01-01

    We assessed whether syringe type, syringe cleaning and distributive syringe sharing were associated with self-reported and laboratory confirmed HCV infection among Hungarian IDUs. Injecting drug users (N=215) were recruited from non-treatment settings in Budapest, Hungary between October 2005 and December 2006. Multivariate logistic regression models identified correlates of self-report of being HCV infected and testing positive for HCV. While 37% tested positive for HCV, 14% of the total (39% of those who tested positive) self-reported being HCV infected. Using any two piece syringes was significantly associated with self-reported HCV infection, while distributive syringe sharing was not associated with self-report of being HCV infected. Engaging in receptive sharing of only one-piece syringes but always cleaning before reuse was not associated with testing HCV positive, while any receptive sharing of only one-piece syringes and not always cleaning before reuse was significantly associated with testing HCV positive. Sharing cookers and squirting drugs from one syringe into another syringe were not associated with testing HCV positive. The high percent of those HCV infected who did not know they were infected highlights the need to provide better access to confidential testing and counseling services. Counseling should emphasize secondary prevention of HCV among HCV infected IDUs. Our findings also indicate that syringe type and syringe cleaning practices may play a role in HCV transmission. Ethnographic research should identify the reasons why IDUs may use two-piece syringes and suggest means to reduce their use. Thorough cleaning of one-piece syringes when sterile syringes are unavailable may be an efficient way to reduce the risk of HCV infection. PMID:19058925

  17. 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

  18. Negotiating access: social barriers to purchasing syringes at pharmacies in Tijuana, Mexico.

    Science.gov (United States)

    Davidson, Peter J; Lozada, Remedios; Rosen, Perth C; Macias, Armando; Gallardo, Manuel; Pollini, Robin A

    2012-07-01

    One common public health response to the emergence of HIV has been the provision of sterile syringes to people who inject drugs. In Mexico specialized syringe exchanges are rare, and the sale of needles through pharmacies is often the only way people who inject drugs can obtain sterile syringes. However, people who inject drugs in Tijuana, Mexico report considerable social barriers to successfully purchasing syringes at pharmacies. Between October 2008 and March 2009 we conducted seven in-depth focus groups with 47 people who inject drugs in Tijuana, Mexico. Focus group transcripts were analysed using a descriptive and thematic approach rooted in grounded theory. We found that injectors offered a number of explanations for why pharmacies were reluctant to sell them syringes, including fear of police; attitudes toward drug use; fear of stereotypical drug user behaviour such as petty theft, violence, or distressing behaviour; and related fears that an obvious drug using clientèle would drive away other customers. Injectors described a range of ways of attempting to re-frame or negotiate interactions with pharmacy staff so that these and related concerns were ameliorated. These included tactics as simple as borrowing cleaner clothing, through to strategies for becoming 'known' to pharmacy staff as an individual rather than as a member of a stigmatized group. Increasing the ability of pharmacy staff and people who inject drugs to successfully negotiate syringe sales are highly desirable. Interventions designed to improve this likelihood need to capitalize on existing solutions developed ad hoc by people who inject drugs and pharmacy staff, and should focus on broadening the range of 'identities' which pharmacy staff are able to accept as legitimate customers. Approaches to achieve this end might include sensitizing pharmacy staff to the needs of people who inject drugs; facilitating individual drug users meeting individual pharmacy staff; and working with drug users

  19. 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.

  20. Extractables and leachables considerations for prefilled syringes.

    Science.gov (United States)

    Jenke, Dennis R

    2014-10-01

    Use of pre-filled syringes as both a packaging and delivery system for pharmaceutical drug products is accelerating. Pre-filled syringes must meet the quality and suitability for use requirements for both systems, including compatibility with the drug product. Relevant incompatibilities between pre-filled syringes and drug products include the safety of syringe-based leachables that accumulate in drug products and the ability of leachables to interact with the drug product's ingredients as such interactions can affect safety, efficacy, stability and physical viability. Relevant suitability considerations for pre-filled syringes are discussed herein and specific examples of suitability for use issues for pre-filled syringes are cited, focusing on extractables associated with pre-filled syringes and leachables derived from such syringes. Aspects considered include the toxicological impact of leachables, their ability to alter the efficacy of drug products and to produce other undesirable outcomes such as aggregation and immunogenic responses. Materials used in pre-filled syringes and the conditions of use minimize the traditional safety risk associated with leachables. However, drug products that use pre-filled syringes are prone to non-traditional interactions such as disruption of protein conformation, leading to potential efficacy, safety and quality issues. In order to qualify pre-filled syringes for use, the traditional approach of measuring extractables and leachables and inferring their effect must be augmented by rigorous compatibility testing. Research into the fundamental relationship between leachables and drug substances will be necessary so the more time- and cost-efficient 'measure and infer' approach can be widely implemented.

  1. Comparison: Flu prescription sales data from a retail pharmacy in the US with Google Flu trends and US ILINet (CDC) data as flu activity indicator.

    Science.gov (United States)

    Patwardhan, Avinash; Bilkovski, Robert

    2012-01-01

    The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r') for five years' aggregate data (2007-2011) was 0.92 (95% CI, 0.90-0.94). The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet) data for 2007 by Centers for Disease Control and Prevention (CDC). The correlation coefficient (Pearson 'r') was 0.97 (95% CI, 0.95-0.98).

  2. Comparison: Flu prescription sales data from a retail pharmacy in the US with Google Flu trends and US ILINet (CDC data as flu activity indicator.

    Directory of Open Access Journals (Sweden)

    Avinash Patwardhan

    Full Text Available The potential threat of bioterrorism along with the emergence of new or existing drug resistant strains of influenza virus, added to expanded global travel, have increased vulnerability to epidemics or pandemics and their aftermath. The same factors have also precipitated urgency for having better, faster, sensitive, and reliable syndromic surveillance systems. Prescription sales data can provide surrogate information about the development of infectious diseases and therefore serve as a useful tool in syndromic surveillance. This study compared prescription sales data from a large drug retailing pharmacy chain in the United States with Google Flu trends surveillance system data as a flu activity indicator. It was found that the two were highly correlated. The correlation coefficient (Pearson 'r' for five years' aggregate data (2007-2011 was 0.92 (95% CI, 0.90-0.94. The correlation coefficients for each of the five years between 2007 and 2011 were 0.85, 0.92, 0.91, 0.88, and 0.87 respectively. Additionally, prescription sales data from the same large drug retailing pharmacy chain in the United States were also compared with US Outpatient Influenza-like Illness Surveillance Network (ILINet data for 2007 by Centers for Disease Control and Prevention (CDC. The correlation coefficient (Pearson 'r' was 0.97 (95% CI, 0.95-0.98.

  3. 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.

  4. Syringe injectable electronics

    Science.gov (United States)

    Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M.

    2015-01-01

    Seamless and minimally-invasive three-dimensional (3D) interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating syringe injection and subsequent unfolding of submicrometer-thick, centimeter-scale macroporous mesh electronics through needles with a diameter as small as 100 micrometers. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with > 90% device yield. We demonstrate several applications of syringe injectable electronics as a general approach for interpenetrating flexible electronics with 3D structures, including (i) monitoring of internal mechanical strains in polymer cavities, (ii) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (iii) in vivo multiplexed neural recording. Moreover, syringe injection enables delivery of flexible electronics through a rigid shell, delivery of large volume flexible electronics that can fill internal cavities and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics. PMID:26053995

  5. High dead-space syringe use among people who inject drugs in Tijuana, Mexico.

    Science.gov (United States)

    Rafful, Claudia; Zule, William; González-Zúñiga, Patricia E; Werb, Dan; Medina-Mora, María Elena; Magis-Rodriguez, Carlos; Strathdee, Steffanie A

    2015-05-01

    High dead-space syringes (HDSS) are believed to confer an elevated risk of acquiring HIV and other blood-borne infections. We identified prevalence and correlates of HDSS use among injection drug users (IDU) in Tijuana, Mexico, where syringe purchase and possession is legal without a prescription. Beginning in 2011, IDU who reported being 18 years or older and injected drugs within the last month were recruited into a prospective study. At baseline and semi-annually, 557 IDU underwent HIV-testing and interviewer-administered surveys. Logistic regression was used to identify correlates of using HDSS. Of 557 IDU, 40% had ever used HDSS, mostly because no other syringe type was available (72%), or because they were easier to get (20%). Controlling for sex and age at first injection, use of HDSS was associated with cocaine as the first drug injected (Adjusted Odds Ratio [AOR]: 2.68; Confidence Interval 95% [CI]: 1.15-6.22), having been stopped or arrested by police (AOR: 1.84; 95% CI: 1.11-3.07), being deported from the US (AOR: 1.64; 95% CI:1.06-2.53), and believing it is illegal to carry syringes (AOR:1.78; 95% CI: 1.01-3.15). Use of HDSS is surprisingly common among IDU in Tijuana. Efforts are needed to expand coverage of low-dead space syringes through existing syringe exchange programs. Education is required to increase awareness of the harms associated with HDSS, and to inform IDU that syringe possession is legal across Mexico.

  6. Syringe sociology.

    Science.gov (United States)

    Vitellone, Nicole

    2015-06-01

    In this article I consider the impact of social epistemologies for understanding the object of the syringe. My aim is to examine the process through which the syringe transforms from an injecting device to a tool of social and political inquiry. Paying particular attention to the uses of Foucault, Becker, Bourdieu, Freud and Latour in empirical studies of injecting heroin use, I examine the sociology of the syringe through the lens of habit and habitus, discourse and deviance, mourning and melancholia, attachment and agencement. In pursuing the theory behind the object my goal is to address a sociological object in the making. In so doing I show how the syringe has been significant for social research, social theory, and sociology. It is the difference the object makes that this article seeks to describe. In tracing the epistemology of the syringe I show how the object is important not just for knowledge of addiction but sociology itself. © London School of Economics and Political Science 2015.

  7. Syringe-injectable electronics.

    Science.gov (United States)

    Liu, Jia; Fu, Tian-Ming; Cheng, Zengguang; Hong, Guosong; Zhou, Tao; Jin, Lihua; Duvvuri, Madhavi; Jiang, Zhe; Kruskal, Peter; Xie, Chong; Suo, Zhigang; Fang, Ying; Lieber, Charles M

    2015-07-01

    Seamless and minimally invasive three-dimensional interpenetration of electronics within artificial or natural structures could allow for continuous monitoring and manipulation of their properties. Flexible electronics provide a means for conforming electronics to non-planar surfaces, yet targeted delivery of flexible electronics to internal regions remains difficult. Here, we overcome this challenge by demonstrating the syringe injection (and subsequent unfolding) of sub-micrometre-thick, centimetre-scale macroporous mesh electronics through needles with a diameter as small as 100 μm. Our results show that electronic components can be injected into man-made and biological cavities, as well as dense gels and tissue, with >90% device yield. We demonstrate several applications of syringe-injectable electronics as a general approach for interpenetrating flexible electronics with three-dimensional structures, including (1) monitoring internal mechanical strains in polymer cavities, (2) tight integration and low chronic immunoreactivity with several distinct regions of the brain, and (3) in vivo multiplexed neural recording. Moreover, syringe injection enables the delivery of flexible electronics through a rigid shell, the delivery of large-volume flexible electronics that can fill internal cavities, and co-injection of electronics with other materials into host structures, opening up unique applications for flexible electronics.

  8. 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.

  9. 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.

  10. 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.

  11. 21 CFR 203.20 - Sales restrictions.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Sales restrictions. 203.20 Section 203.20 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL PRESCRIPTION DRUG MARKETING Sales Restrictions § 203.20 Sales restrictions. Except as provided in § 203.22 or...

  12. Do your syringes count?

    International Nuclear Information System (INIS)

    Brewster, K.

    2002-01-01

    Full text: This study was designed to investigate anecdotal evidence that residual Sestamibi (MIBI) activity vaned in certain situations. For rest studies different brands of syringes were tested to see if the residuals varied. The period of time MIBI doses remained in the syringe between dispensing and injection was also considered as a possible source of increased residual counts. Stress Mibi syringe residual activities were measured to assess if the method of stress test affected residual activity. MIBI was reconstituted using 13 Gbq of Technetium in 3mls of normal saline then boiled for 10 minutes. Doses were dispensed according to department protocol and injected via cannula. Residual syringes were collected for three syringe types. In each case the barrel and plunger were measured separately. As the syringe is flushed during the exercise stress test and not the pharmacological stress test the chosen method was recorded. No relationship was demonstrated between the time MIBI remained in a syringe prior to injection and residual activity. Residual activity was not affected by method of stress test used. Actual injected activity can be calculated if the amount of activity remaining in the syringe post injection is known. Imaging time can be adjusted for residual activity to optimise count statistics. Preliminary results in this study indicate there is no difference in residual activity between syringe brands.Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  13. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study.

    Science.gov (United States)

    Hiremath, Mallayya C; Srivastava, Pooja

    2016-01-01

    The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presence of voids. The obtained data were analyzed using Chi-square test. The results showed significant differences between the four groups for the length of obturation (P tube showed the poor results (37.5% optimal fillings) for the length of obturation. The insulin syringe (79.2% optimal fillings) and local anesthetic syringe (66.7% optimal fillings) showed acceptable results for the length of root canal obturation. However, minor voids were present in all the four techniques used. Endodontic pressure syringe produced the best results in terms of length of obturation and controlling paste extrusion from the apical foramen. However, insulin syringe and local anesthetic syringe can be used as effective alternative methods.

  14. Pharmacists' Perception of the Sale of Non-Clinically Proven Health ...

    African Journals Online (AJOL)

    Pharmacists' Perception of the Sale of Non-Clinically Proven Health Supplements in Penang, Malaysia. ... A total of 10.7 % respondents indicated that the sale of non-clinically proven products result in high profit. Only 25.0 % of the pharmacists ... Keywords: Perception, Health promotion, Urban poor, Health supplements.

  15. 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.

  16. [The effect of colored syringes and a colored sheet on the incidence of syringe swaps during anesthetic management].

    Science.gov (United States)

    Hirabayashi, Yoshihiro; Kawakami, Takayuki; Suzuki, Hideo; Igarashi, Takashi; Saitoh, Kazuhiko; Seo, Norimasa

    2005-09-01

    Syringe swap is an important problem in anesthetic care, causing harm to patients. We examined the effect of colored syringe and a colored sheet on the incidence of syringe swaps during anesthetic management. We determined the color code. The blue-syringe contains local anesthetics; yellow-syringe, sympathomimetic drugs; and white-syringe with a red label fixed opposite the scale, muscle relaxants. The colored sheet displays the photographs of the syringe with drug name, dose and volume. The colored syringe and colored sheet were supplied for use from February 2004. We compared the incidence of syringe swaps during the period from February 2004 to January 2005 with that from February 2003 to January 2004. Although five syringe swaps were recorded from February 2003 to January 2004, in 5901 procedures, we encountered no syringe swaps from February 2004 to January 2005, in 6078 procedures. The colored syringe and colored sheet significantly decreased the incidence of syringe swaps during anesthetic management (P sheet together with colored syringes can prevent syringe swaps during anesthesia.

  17. 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 ...

  18. Legal syringe purchases by injection drug users, Brooklyn and Queens, New York City, 2000-2001.

    Science.gov (United States)

    Des Jarlais, Don C; McKnight, Courtney; Friedmann, Patricia

    2002-01-01

    To assess preliminary results of the Expanded Syringe Access Demonstration Program (ESAP) in New York City. Temporal trends of pharmacy use among injection drug users (IDUs) in Brooklyn and Queens were analyzed from December 2000 through December 2001. Brooklyn and Queens, New York City. PARTIPANTS: IDUs. Attempts to purchase syringes from pharmacies and success in doing so. Of the 1,072 IDUs interviewed from December 2000 through December 2001, the majority were daily heroin injectors, but there was also substantial speedball and cocaine injection. There was a clear increase over time in both the percentage of subjects who attempted to purchase syringes in pharmacies and in the percentage who successfully purchased syringes. Among IDUs interviewed 4 or more months after ESAP began, large majorities of those who attempted to purchase syringes were successful in doing so. No differences in use of ESAP by IDUs were identified in Brooklyn versus Queens: 27% of IDUs interviewed in Queens reported that they had attempted to purchase syringes in pharmacies versus 28% in Brooklyn. Persons who reported injecting on a daily or more frequent basis were more likely to have attempted pharmacy purchases than persons who reported injecting less frequently, 32% versus 21%. The ESAP program has led to an increase in the use of pharmacies as sources of sterile injection equipment among IDUs in New York City. The extent to which pharmacies become an important source of sterile injection equipment and the effect of legal pharmacy sales on risk behaviors for human immunodeficiency virus (HIV) infection remain to be determined.

  19. Non-medical use of psychoactive prescription drugs is associated with fatal poisoning.

    Science.gov (United States)

    Haukka, Jari; Kriikku, Pirkko; Mariottini, Claudia; Partonen, Timo; Ojanperä, Ilkka

    2018-03-01

    The aims of this study were to estimate the prevalence and predictors of non-medical substance use, and to assess the association between non-medical substance use and fatal poisoning or history of drug abuse in Finland. Retrospective cohort study of all medico-legally investigated death cases in Finland. The postmortem toxicology database was linked together with the register on reimbursed prescription medicines. All postmortem cases between 2011 and 2013 positive for one or more of the following drugs: oxycodone, fentanyl, tramadol, clonazepam, gabapentin, pregabalin, tizanidine, olanzapine, quetiapine, risperidone, alprazolam, zolpidem, mirtazapine and bupropion, n = 2974. Non-medical use of substance was the outcome variable. Predictors were the following: gender, residence at the time of death, place of death, blood alcohol concentration, age, drug abuse, number of prescriptions of any psychoactive drugs in last year and proportion of prescriptions issued by psychiatrist in last year. In 50.4% of the studied cases, at least one drug was detected without a prescription. Clonazepam, alprazolam and tramadol were the most prevalent non-medical findings in these cases (6.6, 6.1 and 5.6%, respectively). The risk of non-medical use of prescription drugs was especially high in cases with history of drug abuse (88.5%) and in fatal poisonings (71.0%). The proportion of non-medical use of the studied substances varied between 5.9% [95% confidence interval (CI) = 3.1-10.1%)] for risperidone and 55.7% for fentanyl (95% CI = 44.1-66.9%). Valid prescription for one or more of any psychoactive drug was associated with lower odds for non-medical use of the studied substances. Additionally, the higher the proportion of psychoactive drugs prescribed by a psychiatrist, the lower the probability of non-medical use. Non-prescribed psychoactive drugs are found commonly at postmortem in drug poisoning deaths in Finland, with history of drug abuse being a major contributing

  20. Accounting Practices Regarding the Non-Current Assets Held for Sale

    Directory of Open Access Journals (Sweden)

    Marinela Manea

    2010-12-01

    Full Text Available Generally the non-current assets, and especially the tangible assets, are held by the entity (as it results from their very definition in order to be used in the production of goods or for services, to be rented to the thirds or to be used for administrative purposes during several periods. For the time interval that a non-current asset is not classified as being held for sale, its recognition and implicitly its assessment will be done in accordance with the provisions of the applicable International Financial Reporting Standards; after the classification of the respective asset as being held with the intention of subsequent sale there will be applicable the provisions of the contemporary IFRS norm 5 “Non-current assets held for sale and discontinued activities”.

  1. Trends in Non-prescription Drug Recalls in Japan.

    Science.gov (United States)

    Yamamoto, Chikoto; Ishida, Takuya; Osawa, Takashi; Naito, Takafumi; Kawakami, Junichi

    2016-01-01

    Recalls of non-prescription drugs can contribute to preventing harm to human health, however, they also interrupt the supply of medicines to the market. The aim of the present study was to investigate the trends in non-prescription drug recalls in Japan. Class I, II, and III recalls reported from April 2009 to March 2014 were obtained from the websites of the Ministry of Health, Labour and Welfare and the Pharmaceuticals and Medical Devices Agency. Each drug recall was classified according to year, dosage form, therapeutic category, and reasons for the recall. The trends over the 5 year period were assessed for each class. A total of 220 recalls were reported in the 5-year study period. The numbers of drug recalls were 21, 16, 80, 58, and 45 in 2009, 2010, 2011, 2012, and 2013, respectively. The drugs recalled consisted of 177 internal medications, 35 topical agents, and 8 others. Drug recalls were observed in 12 therapeutic categories of drug effects. The largest number of recalls was for Chinese herbal medicines and crude drugs. Of all the drug recalls in 2011, Chinese herbal medicines and crude drugs produced by one manufacturer accounted for 84%. Slightly more than half (54%) of drug recalls were due to a violation of the regulations. One manufacturer recalled many drugs because of non-compliance with the standard regulations for manufacturing drugs after 2011. In conclusion, non-prescription drug recalls can occur for any drug regardless of the dosage form and therapeutic category.

  2. A systematic review in select countries of the role of the pharmacist in consultations and sales of non-prescription medicines in community pharmacy.

    Science.gov (United States)

    van Eikenhorst, Linda; Salema, Nde-Eshimuni; Anderson, Claire

    Much has been studied in regard to non-prescription medicines (NPMs), but the impact of greater emphasis toward patient self-selection of such agents is still not well understood, and evidence in the literature might be equivocal. The aim was to examine whether or not pharmacist interventions are important in the sale of NPMs and to summarize the evidence of pharmacists' contribution in maintaining patient safety and improving the quality of consultations involving NPMs. Seven online databases were searched to identify the literature on studies conducted within the UK and in countries comparable to the UK reporting on consultations and selling of NPMs published between 1980 and 2013. All study designs except for quantitative surveys were eligible for inclusion into the review. The data extraction and quality assessment were performed according to the National Institute for Health and Care Excellence guidelines. The data extracted from the studies were analyzed and presented qualitatively. Eighty-three studies from an original 12,879 citations were included in this review. Just under half of the studies were published between 2000 and 2009 (n = 38; 46%). Thirty-three (44%) of the studies were conducted in the UK. The review showed that in terms of the contribution of community pharmacy staff in consultations for NPMs, non-pharmacist staff dealt with a large proportion of the consultations and pharmacists were usually involved in the consultation through referral from non-pharmacist staff member. Counseling was not consistently offered to everyone. Where counseling was provided it was not always of sufficient quality. Consultations were performed much better when symptoms were presented compared to when people made a direct product request. Pharmacists were reported to conduct better consultations than non-pharmacist staff. There was evidence to suggest that where counseling was appropriately provided this afforded the person a safe environment to utilize their

  3. Methods To Determine the Silicone Oil Layer Thickness in Sprayed-On Siliconized Syringes.

    Science.gov (United States)

    Loosli, Viviane; Germershaus, Oliver; Steinberg, Henrik; Dreher, Sascha; Grauschopf, Ulla; Funke, Stefanie

    2018-01-01

    The silicone lubricant layer in prefilled syringes has been investigated with regards to siliconization process performance, prefilled syringe functionality, and drug product attributes, such as subvisible particle levels, in several studies in the past. However, adequate methods to characterize the silicone oil layer thickness and distribution are limited, and systematic evaluation is missing. In this study, white light interferometry was evaluated to close this gap in method understanding. White light interferometry demonstrated a good accuracy of 93-99% for MgF 2 coated, curved standards covering a thickness range of 115-473 nm. Thickness measurements for sprayed-on siliconized prefilled syringes with different representative silicone oil distribution patterns (homogeneous, pronounced siliconization at flange or needle side, respectively) showed high instrument (0.5%) and analyst precision (4.1%). Different white light interferometry instrument parameters (autofocus, protective shield, syringe barrel dimensions input, type of non-siliconized syringe used as base reference) had no significant impact on the measured average layer thickness. The obtained values from white light interferometry applying a fully developed method (12 radial lines, 50 mm measurement distance, 50 measurements points) were in agreement with orthogonal results from combined white and laser interferometry and 3D-laser scanning microscopy. The investigated syringe batches (lot A and B) exhibited comparable longitudinal silicone oil layer thicknesses ranging from 170-190 nm to 90-100 nm from flange to tip and homogeneously distributed silicone layers over the syringe barrel circumference (110- 135 nm). Empty break-loose (4-4.5 N) and gliding forces (2-2.5 N) were comparably low for both analyzed syringe lots. A silicone oil layer thickness of 100-200 nm was thus sufficient for adequate functionality in this particular study. Filling the syringe with a surrogate solution including short

  4. Comparative evaluation of endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe in obturation of primary teeth: An in vitro study

    OpenAIRE

    Hiremath, Mallayya C.; Srivastava, Pooja

    2016-01-01

    Purpose: The purpose of this in vitro study was to compare four methods of root canal obturation in primary teeth using conventional radiography. Materials and Methods: A total of 96 root canals of primary molars were prepared and obturated with zinc oxide eugenol. Obturation methods compared were endodontic pressure syringe, insulin syringe, jiffy tube, and local anesthetic syringe. The root canal obturations were evaluated by conventional radiography for the length of obturation and presenc...

  5. [Trial manufacture of a plunger shield for a disposable plastic syringe].

    Science.gov (United States)

    Murakami, Shigeki; Emoto, Takashi; Mori, Hiroshige; Fujita, Katsuhisa; Kubo, Naoki

    2008-08-20

    A syringe-type radiopharmaceutical being supplied by a manufacturer has a syringe shield and a plunger shield, whereas an in-hospital labeling radiopharmaceutical is administered by a disposable plastic syringe without the plunger shield. In cooperation with Nihon Medi-Physics Co. Ltd., we have produced a new experimental plunger shield for the disposable plastic syringe. In order to evaluate this shielding effect, we compared the leaked radiation doses of our plunger shield with those of the syringe-type radiopharmaceutical (Medi shield type). Our plunger shield has a lead plate of 21 mm in diameter and 3 mm thick. This shield is equipped with the plunger-end of a disposal plastic syringe. We sealed 99mTc solution into a plastic syringe (Terumo Co.) of 5 ml with our plunger shield and Medi shield type of 2 ml. We measured leaked radiation doses around syringes using fluorescent glass dosimeters (Dose Ace). The number of measure points was 18. The measured doses were converted to 70 microm dose equivalent at 740 MBq of radioactivity. The results of our plunger shield and the Medi shield type were as follows: 4-13 microSv/h and 3-14 microSv/h at shielding areas, 3-545 microSv/h and 6-97 microSv/h at non-shielding areas, 42-116 microSv/h and 88-165 microSv/h in the vicinity of the syringe shield, and 1071 microSv/h and 1243 microSv/h at the front of the needle. For dose rates of shielding areas around the syringe, the shielding effects were approximately the same as those of the Medi shield type. In conclusion, our plunger shield may be useful for reducing finger exposure during the injection of an in-hospital labeled radiopharmaceutical.

  6. Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use.

    Science.gov (United States)

    Daubresse, Matthew; Hutfless, Susan; Kim, Yoonsang; Kornfield, Rachel; Qato, Dima M; Huang, Jidong; Miller, Kay; Emery, Sherry L; Alexander, G Caleb

    2015-07-01

    The United States is one of only two countries that permit direct-to-consumer advertising (DTCA) of prescription drugs, and many questions remain regarding its effects. To quantify the association between asthma-related DTCA, pharmacy sales, and healthcare use. This was an ecological study from 2005 through 2009 using linked data from Nielsen (DTCA television ratings), the IMS Health National Prescription Audit (pharmacy sales), and the MarketScan Commercial Claims data (healthcare use) for 75 designated market areas in the United States. We used multilevel Poisson regression to model the relationship between DTCA and rates of prescriptions and use within and across designated market areas. Main outcome measures include (1) volume of total, new, and refilled prescriptions for advertised products based on pharmacy sales; (2) prescription claims for asthma medications; and asthma-related (3) emergency department use, (4) hospitalizations, and (5) outpatient encounters among the commercially insured. Four Food and Drug Administration-approved asthma medicines were advertised during the period examined: (1) fluticasone/salmeterol (Advair), (2) mometasone furoate (Asmanex), (3) montelukast (Singulair), and (4) budesonide/formoterol (Symbicort). After adjustment, each additional televised advertisement was associated with 2% (incident rate ratio, 1.02; 95% confidence interval, 1.01-1.03) higher pharmacy sales rate from 2005 through 2009, although this effect varied across the three consistently advertised therapies examined. Among the commercially insured, DTCA was positively and significantly associated with emergency room visits related to asthma (incident rate ratio, 1.02; 95% confidence interval, 1.01-1.04), but there was no relationship with hospitalizations or outpatient encounters. Among this population, DTCA was associated with higher prescription sales and asthma-related emergency department use.

  7. Non-Medical Prescription Stimulant Use in Graduate Students: Relationship With Academic Self-Efficacy and Psychological Variables.

    Science.gov (United States)

    Verdi, Genevieve; Weyandt, Lisa L; Zavras, Brynheld Martinez

    2016-09-01

    The objective of this study was to examine graduate students' non-medical use of prescription stimulant medication, and the relationship between non-medical use of prescription stimulants with academic self-efficacy, psychological factors (i.e., anxiety, depression, and stress), and internal restlessness. The sample consisted of 807 graduate students from universities located in five geographic regions of the United States. Past-year rates of self-reported non-medical use were determined to be 5.9%, with overall lifetime prevalence of 17.5%. Observed self-reported non-medical use of prescription stimulant medications was significantly correlated with self-reported levels of anxiety and stress, various aspects of internal restlessness, and perceived safety of the medications. Findings support graduate students' motivations of non-medical prescription stimulant use to be both academic and social in nature. Effective prevention and education efforts are needed to help address the non-medical use of prescription stimulants by graduate students on university campuses. © The Author(s) 2014.

  8. 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.

  9. Managing sleep problems using non-prescription medications and the role of community pharmacists: older adults' perspectives.

    Science.gov (United States)

    Abraham, Olufunmilola; Schleiden, Loren J; Brothers, Amanda L; Albert, Steven M

    2017-12-01

    To examine older adults' perspectives regarding managing sleep problems through selection and use of non-prescription sleep aids, and the role of pharmacists. Telephone interviews were conducted from May to June 2015 with 116 individuals aged ≥60 years in Pittsburgh, Pennsylvania. Participants reported in a previous survey to have used at least one non-prescription sleep aid in the past 30 days and were willing to participate in a follow-up interview. Interview guides were designed to elicit perspectives of sleep problems, selection and use of non-prescription sleep aids, and consultation with healthcare professionals. Interview transcripts underwent content analysis. Four themes emerged as follows: experiences with sleep problems, selection of non-prescription sleep aids, non-prescription sleep aid use and interactions with healthcare professionals. Over half of participants reported using a non-prescription sleep aid for >1 year, were satisfied with its use and perceived it improved sleep quality. Participants commonly used an antihistamine-only sleep aid; 36% of participants self-recommended their sleep aid; and 16% of participants consulted healthcare professionals. Few participants read medication dosage labels (22%), side effects or warnings (19%), and many reported they disregarded directions. Participants did not typically consult pharmacists about sleep problems (65%) but perceived that they could assist with medication concerns. Although most participants had favourable perceptions of non-prescription sleep aids, older adults may be inappropriately using non-prescription sleep aids to self-manage sleep problems by frequently disregarding medication labels and directions for safe use. Also, few older adults are discussing their sleep aid selection and use with pharmacists. © 2017 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.

  10. Effect of Direct-to-Consumer Advertising on Asthma Medication Sales and Healthcare Use

    Science.gov (United States)

    Daubresse, Matthew; Hutfless, Susan; Kim, Yoonsang; Kornfield, Rachel; Qato, Dima M.; Huang, Jidong; Miller, Kay; Emery, Sherry L.

    2015-01-01

    Rationale: The United States is one of only two countries that permit direct-to-consumer advertising (DTCA) of prescription drugs, and many questions remain regarding its effects. Objectives: To quantify the association between asthma-related DTCA, pharmacy sales, and healthcare use. Methods: This was an ecological study from 2005 through 2009 using linked data from Nielsen (DTCA television ratings), the IMS Health National Prescription Audit (pharmacy sales), and the MarketScan Commercial Claims data (healthcare use) for 75 designated market areas in the United States. We used multilevel Poisson regression to model the relationship between DTCA and rates of prescriptions and use within and across designated market areas. Main outcome measures include (1) volume of total, new, and refilled prescriptions for advertised products based on pharmacy sales; (2) prescription claims for asthma medications; and asthma-related (3) emergency department use, (4) hospitalizations, and (5) outpatient encounters among the commercially insured. Measurements and Main Results: Four Food and Drug Administration–approved asthma medicines were advertised during the period examined: (1) fluticasone/salmeterol (Advair), (2) mometasone furoate (Asmanex), (3) montelukast (Singulair), and (4) budesonide/formoterol (Symbicort). After adjustment, each additional televised advertisement was associated with 2% (incident rate ratio, 1.02; 95% confidence interval, 1.01–1.03) higher pharmacy sales rate from 2005 through 2009, although this effect varied across the three consistently advertised therapies examined. Among the commercially insured, DTCA was positively and significantly associated with emergency room visits related to asthma (incident rate ratio, 1.02; 95% confidence interval, 1.01–1.04), but there was no relationship with hospitalizations or outpatient encounters. Conclusions: Among this population, DTCA was associated with higher prescription sales and asthma-related emergency

  11. Moving beyond non-engagement on regulated needle-syringe exchange programs in Australian prisons

    Directory of Open Access Journals (Sweden)

    Levy Michael

    2009-05-01

    Full Text Available Abstract Background Australia is at a fork in the road with the possibility of a needle-syringe exchange program (NSP to be introduced at the new prison in the ACT. However, the current situation is characterised by non-engagement from major stakeholders. We explore why informed discussion will not be enough to convince prison officers, policy makers and the wider community of the benefits of prison-based NSPs. Other methods of engagement and communication will be proposed – in that may provide avenues for "breakthrough". Methods A review of the literature on needle-syringe exchanges and harm reduction strategies within the context of prisons and prisoner health was conducted. Literature on strategies to change attitudes and move beyond intractable situations was also consulted. In addition, one author, DM, conducted a two-hour interview with an ex-prison officer. Results No studies were found which investigated the potential efficacy of interventions to modify attitudes or behaviours in the specific context of introducing an NSP into a prison. Nonetheless, several theories were identified which may explain the failure of informed discussion alone to create change in this situation and may therefore lead to suggestions for engagement and communication to move towards a resolution Discussion Cognitive-behavioural therapy highlights the importance of individual cognitions and how they shape behaviours in any change campaign. Social identity theory emphasizes changes to social processes that may open the prison officer workforce to change. Peace studies also suggests socialization strategies such as observing an established and effective prison-based needle-syringe exchange. Social marketing provides suggestions on how to sell an exchange to ensuring the benefits are framed to outweigh the costs. Conclusion Psychology, peace studies and social marketing all agree people's views must be carefully collected and analysed if people are going to be

  12. Use of Non-Prescription Remedies by Ghanaian Human Immunodeficiency Virus-Positive Persons on Antiretroviral Therapy.

    Science.gov (United States)

    Laar, Amos K; Kwara, Awewura; Nortey, Priscillia A; Ankomah, Augustine K; Okyerefo, Michael P K; Lartey, Margaret Y

    2017-01-01

    Inappropriate use of non-prescription remedies by persons living with human immunodeficiency virus (PLHIV) may result in adverse events or potentiate non-adherence to prescribed medications. This study investigated the use of non-prescription remedies among PLHIV receiving antiretroviral therapy (ART) from four treatment centers in southern Ghana. A mixed method design using quantitative and qualitative methods was used. This article focuses on the quantitative survey of 540 respondents. Univariate analysis was used to generate descriptive tabulations of key variables. Bivariate analysis and logistic regression modeling, respectively, produced unadjusted and adjusted associations between background attributes of PLHIV and the use of non-prescription remedies. A p -value of antiretroviral medications (ARVs)-46% or administered with ARVs but at different times during the day (43%). Some of the remedies were reportedly prescribed by health workers, or self-initiated during periods of ARVs shortage. Others took them based on their perception of their efficacy. Bivariate level analysis identified ART clinic site, place of residence, and ARV adherence monitoring to be significantly associated with the use of non-prescription remedies ( p  < 0.05). Multiple logistic regression analysis controlling for covariates confirmed the location of ART clinic as the only predictor of the use of non-prescription remedies. Compared to clients at the large urban teaching hospital (Korle-Bu Fevers Unit ART center), those at the district level (Atua ART center) were ninefold more likely to use non-prescription remedies [adjusted odds ratio (AOR) = 8.84; 95% confidence interval (CI) 2.83-33.72]. Those from a district level mission hospital (St. Martin's ART center) were threefold as likely to use these remedies (AOR = 2.610; 95% CI 1.074-9.120). The use of non-prescription remedies by PLHIV on ART is common in southern Ghana. Usage is mostly self-initiated because of perceived

  13. Safety syringes and anti-needlestick devices in orthopaedic surgery.

    Science.gov (United States)

    Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

    2011-09-07

    The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting

  14. Patterns and predictors of non-prescription medicine use among Malaysian pharmacy patrons: a national cross sectional study.

    Directory of Open Access Journals (Sweden)

    Mohamed Azmi Hassali

    Full Text Available OBJECTIVE: The study aims to evaluate the predictors of non-prescription medicine purchasing patterns among pharmacy patrons in Malaysia. METHODS: A cross-sectional nationwide study was undertaken in 2011 in sixty randomly selected community pharmacies across 14 Malaysian states. A pharmacy exit survey was conducted over a 6-month period across Malaysia. A one-stage random cluster sampling technique was employed as there was no national sampling framework available for conducting this survey. Face-to-face interviews using a validated and pre-tested questionnaire were conducted by trained data collectors. The non-prescription medicine purchasing pattern was explored and analysed descriptively. Chi-square/Fisher exact test was used to determine the association between study variables. Multinomial logistic regression analysis was used to determine the predictors of type of non-prescription medicine purchased. RESULTS: A total of 2729 pharmacy patrons agreed to participate in 60 selected pharmacy outlets. A total of 3462 non-prescription medicine were purchased during the study period with an average of 1.3 medicines per participant. Most of the non-prescription medicine purchased was meant for alimentary tract and metabolism (31.8%, followed by respiratory system (19.4% and musculoskeletal system (15.8% usage. Factors found to be associated with the choice of non-prescription medicine purchased were age group [χ2 = 170.75, (df = 57, p<0.01], locality [χ2 = 48.16, (df = 19, p<0.01], gender [χ2 = 32.93, (df = 13, p = 0.002], ethnic group [χ2 = 118.89, (df = 39, p<0.01] and type of occupation [χ2 = 222.434, (df = 117, p<0.01]. Non-prescription medicine purchased defined about 20% of the variance in the combination of predictors such as locality, gender, age, ethnicity, type of occupation and household income. CONCLUSION: The predictors for selection of non-prescription medicine were locality (urban or rural, gender, age, ethnicity, type of

  15. Syringe confiscation as an HIV risk factor: the public health implications of arbitrary policing in Tijuana and Ciudad Juarez, Mexico.

    Science.gov (United States)

    Beletsky, Leo; Lozada, Remedios; Gaines, Tommi; Abramovitz, Daniela; Staines, Hugo; Vera, Alicia; Rangel, Gudelia; Arredondo, Jaime; Strathdee, Steffanie A

    2013-04-01

    Female sex workers who inject drugs (FSW-IDUs) face elevated risk for HIV/STIs and constitute a key population for public health prevention. Through direct and indirect pathways including human rights violations, policing practices like syringe confiscation can compound FSW-IDU health risk and facilitate the spread of disease. We studied correlates of experiencing syringe confiscation among FSW-IDUs in northern Mexico, where formal policy allows for syringes to be available over the counter without a prescription, but police practices are often at odds with the law. FSW-IDUs reporting recent syringe sharing and unprotected sex with clients in Tijuana and Ciudad Juarez were administered surveys and HIV/STI testing. Logistic regression was used to identify correlates of syringe confiscation. Among 624 respondent FSW-IDUs, prevalence of syringe confiscation in the last 6 months was 48%. The following factors were positively associated with syringe confiscation: testing positive for HIV (adjusted odds ratio [aOR] = 2.54, 95% confidence interval [CI] = 1.11-5.80), reporting sexual abuse by police (aOR = 12.76, 95% CI = 6.58-24.72), engaging in groin injection (aOR = 1.84, 95% CI = 1.15-2.93), injecting in public (aOR = 1.64; 95% CI = 1.14-2.36), and obtaining syringes from pharmacies (aOR = 1.54; 95% CI = 1.06-2.23). Higher education level was negatively associated with syringe confiscation (aOR = 0.92, 95% CI = 0.87-0.98) as was frequent injection with clients within the last month (aOR = 0.64, 95% CI = 0.44-0.94). This analysis adds to the body of evidence linking unauthorized law enforcement actions targeting high-risk groups with HIV and other adverse health outcomes. Using a public health lens to conceptualize abuse as a structural risk factor, we advocate for multi-prong prevention, systematic monitoring, and evidence-based intervention response to deleterious police practices.

  16. Use of Non-Prescription Remedies by Ghanaian Human Immunodeficiency Virus-Positive Persons on Antiretroviral Therapy

    Directory of Open Access Journals (Sweden)

    Amos K. Laar

    2017-05-01

    Full Text Available BackgroundInappropriate use of non-prescription remedies by persons living with human immunodeficiency virus (PLHIV may result in adverse events or potentiate non-adherence to prescribed medications. This study investigated the use of non-prescription remedies among PLHIV receiving antiretroviral therapy (ART from four treatment centers in southern Ghana.MethodsA mixed method design using quantitative and qualitative methods was used. This article focuses on the quantitative survey of 540 respondents. Univariate analysis was used to generate descriptive tabulations of key variables. Bivariate analysis and logistic regression modeling, respectively, produced unadjusted and adjusted associations between background attributes of PLHIV and the use of non-prescription remedies. A p-value of < 0.05 was considered statistically significant. All analyses were performed using IBM SPSS Statistics for Windows, Version 20.0.ResultsOne out of three respondents reported the use of non-prescription remedies at least once within 3 months of the survey. Most of these were locally made and included “Angel natural bitters, concoctions from the Christian prayer centers, garlic, and mahogany syrups.” These remedies were used concomitantly with antiretroviral medications (ARVs—46% or administered with ARVs but at different times during the day (43%. Some of the remedies were reportedly prescribed by health workers, or self-initiated during periods of ARVs shortage. Others took them based on their perception of their efficacy. Bivariate level analysis identified ART clinic site, place of residence, and ARV adherence monitoring to be significantly associated with the use of non-prescription remedies (p < 0.05. Multiple logistic regression analysis controlling for covariates confirmed the location of ART clinic as the only predictor of the use of non-prescription remedies. Compared to clients at the large urban teaching hospital (Korle-Bu Fevers Unit ART

  17. 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.

  18. Non-medical use of prescription stimulants for academic purposes among college students: a test of social learning theory.

    Science.gov (United States)

    Ford, Jason A; Ong, Julianne

    2014-11-01

    The current research examines whether measures associated with Akers' social learning theory are related to non-medical use of prescription stimulants for academic reasons among college students. We examine data from a sample of 549 undergraduate students at one public university in the Southeastern United States. We estimate several logistic regression models to test our hypotheses. The findings indicated that roughly 17% of students reported non-medical use of prescription stimulants for academic reasons during the past year. In separate models, all four of the social learning measures were significantly correlated to non-medical use. In the complete model, the risk of non-medical prescription stimulant use for academic reasons was increased for respondents who reported more of their friends used and also for respondents who believed that prescription stimulants were an effective study aid. The current research fills an important gap in the literature regarding theoretical explanations for non-medical prescription stimulant use. Given the high prevalence of non-medical prescription stimulant use and the known risks associated with non-medical use this research can help inform intervention strategies for college populations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: a cross sectional study.

    Science.gov (United States)

    Bin Abdulhak, Aref A; Altannir, Mohamad A; Almansor, Mohammed A; Almohaya, Mohammed S; Onazi, Atallah S; Marei, Mohammed A; Aldossary, Oweida F; Obeidat, Sadek A; Obeidat, Mustafa A; Riaz, Muhammad S; Tleyjeh, Imad M

    2011-07-07

    Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potential associated risks of such practice in Riyadh, Saudi Arabia, by simulation of different clinical scenarios. A cross sectional study of a quasi-random sample of pharmacies stratified by the five regions of Riyadh. Each pharmacy was visited once by two investigators who simulated having a relative with a specific clinical illness (sore throat, acute bronchitis, otitis media, acute sinusitis, diarrhea, and urinary tract infection (UTI) in childbearing aged women). A total of 327 pharmacies were visited. Antibiotics were dispensed without a medical prescription in 244 (77.6%) of 327, of which 231 (95%) were dispensed without a patient request. Simulated cases of sore throat and diarrhea resulted in an antibiotic being dispensed in (90%) of encounters, followed by UTI (75%), acute bronchitis (73%), otitis media (51%) and acute sinusitis (40%). Metronidazole (89%) and ciprofloxacin (86%) were commonly given for diarrhea and UTI, respectively, whereas amoxicillin/clavulanate was dispensed (51%) for the other simulated cases. None of the pharmacists asked about antibiotic allergy history or provided information about drug interactions. Only 23% asked about pregnancy status when dispensing antibiotics for UTI-simulated cases. We observed that an antibiotic could be obtained in Riyadh without a medical prescription or an evidence-based indication with associated potential clinical risks. Strict enforcement and adherence to existing regulations are warranted.

  20. Non prescribed sale of antibiotics in Riyadh, Saudi Arabia: A Cross Sectional Study

    Directory of Open Access Journals (Sweden)

    Obeidat Sadek A

    2011-07-01

    Full Text Available Abstract Background Antibiotics sales without medical prescriptions are increasingly recognized as sources of antimicrobial misuse that can exacerbate the global burden of antibiotic resistance. We aimed to determine the percentage of pharmacies who sell antibiotics without medical prescriptions, examining the potential associated risks of such practice in Riyadh, Saudi Arabia, by simulation of different clinical scenarios. Methods A cross sectional study of a quasi-random sample of pharmacies stratified by the five regions of Riyadh. Each pharmacy was visited once by two investigators who simulated having a relative with a specific clinical illness (sore throat, acute bronchitis, otitis media, acute sinusitis, diarrhea, and urinary tract infection (UTI in childbearing aged women. Results A total of 327 pharmacies were visited. Antibiotics were dispensed without a medical prescription in 244 (77.6% of 327, of which 231 (95% were dispensed without a patient request. Simulated cases of sore throat and diarrhea resulted in an antibiotic being dispensed in (90% of encounters, followed by UTI (75%, acute bronchitis (73%, otitis media (51% and acute sinusitis (40%. Metronidazole (89% and ciprofloxacin (86% were commonly given for diarrhea and UTI, respectively, whereas amoxicillin/clavulanate was dispensed (51% for the other simulated cases. None of the pharmacists asked about antibiotic allergy history or provided information about drug interactions. Only 23% asked about pregnancy status when dispensing antibiotics for UTI-simulated cases. Conclusions We observed that an antibiotic could be obtained in Riyadh without a medical prescription or an evidence-based indication with associated potential clinical risks. Strict enforcement and adherence to existing regulations are warranted.

  1. Serotonin syndrome following overdose of a non-prescription slimming product containing sibutramine: a case report.

    Science.gov (United States)

    Lam, Pui Kin; Leung, K S; Wong, T W; Lee, H H C; Tang, M H Y; Mak, T W L

    2012-04-01

    Non-prescription slimming products are popular and can be easily purchased from the Internet. However, adulteration of these products with undeclared substances including prescription drugs is not uncommon. We report a case of serotonin syndrome after an overdose of a non-prescription product containing sibutramine. A 21-year-old woman presented with somnolence, sinus tachycardia, generalised increase in tone, hyper-reflexia and clonus more prominent in the lower limbs after an intentional overdose of a non-prescription slimming product obtained from the Internet. The product was later found to contain sibutramine and other substances such as animal thyroid tissues, caffeine and phenolphthalein. Quantitative analysis of patient's serum on presentation revealed a sibutramine concentration of 112 ng/mL, which far exceeded the reported peak serum concentration after a single oral dose of 15 mg (the maximum daily recommended dose). No other culpable agent was identified. The overall clinical presentation was compatible with serotonin syndrome associated with sibutramine overdose. The patient made a full recovery after supportive management. This case highlighted the health threat posed by non-prescription slimming products sold over the Internet. Sibutramine overdose can result in serotonin syndrome, as in overdose of other serotonergic agents. Early recognition and timely supportive treatment are essential to ensure a good clinical outcome.

  2. SU-F-T-57: Delivered Activity Accuracy of Radium 223 Dichloride Injections, When Being Administrated for Castration Resistant Prostate Cancer, Symptomatic Bone Metastases. The Impact of Residual Activity in the Spent Syringe and Dispensing Accuracy of Ra 223

    International Nuclear Information System (INIS)

    Jennings, G

    2016-01-01

    Purpose: To quantify the delivered activity accuracy of Radium 223 dichloride injections, when being administrated for castration – resistant prostate cancer, symptomatic bone metastases. The impact of residual activity in the spent syringe and dispensing accuracy of Ra 223. Methods: The administration is by slow intravenous injection over 1 minute followed by double flushing of the 10 mL syringe and IV with saline. Eighty (80) procedures was used to investigate variations in the activity from the amount prescribed (µCi) = 1.35 × Patient weight Kg. The Activity dispensed into a 10mL syringe using a NIST traceable Capintec CRC-25R Chamber and a cross calibrated capintec CRC-15R to measure activity in the syringe immediately before and after administration Results: The patients weight range from 121Ib to 235lb and doses ranging 74.25 µCi to 144.2 µCi. The deviation of dispensed dose vs Prescribed dose average +2.1% with a range of −1.1% to +5.7%. The Dose measured before administration ranges 79.3 µCi to 154.9 µCi. Deviation from the dispensed dose was show to average +2.9% with a range of −0.8% to +7.3%. The average residual dose post injection was 2.5 µCi or 2.2% of the pre injection activity. Ranging from 0.9 µCi to 6.2 µCi, 0.7% to 5.4% respectively. Subtracting the residual activity from that measured activity before injection and comparing it to prescription dose was shown to have an average variation of +2.7% with a range of −0.8% to 7.4%. Conclusion: The case resulted in the 6.2 µCi maximum residual dose had two syringes. A small, 82.8 µCi activity, case resulted in the 7.4% maximum variation in measures less residual verses prescription dose. The average +2.1 % dispenses activity of Ra 223 over the prescription dosage was seen to counteract the average 2.2% residual dosage found to remain in the syringe

  3. SU-F-T-57: Delivered Activity Accuracy of Radium 223 Dichloride Injections, When Being Administrated for Castration Resistant Prostate Cancer, Symptomatic Bone Metastases. The Impact of Residual Activity in the Spent Syringe and Dispensing Accuracy of Ra 223

    Energy Technology Data Exchange (ETDEWEB)

    Jennings, G [Marsden Medical Physics Associates, Denville, NJ (United States)

    2016-06-15

    Purpose: To quantify the delivered activity accuracy of Radium 223 dichloride injections, when being administrated for castration – resistant prostate cancer, symptomatic bone metastases. The impact of residual activity in the spent syringe and dispensing accuracy of Ra 223. Methods: The administration is by slow intravenous injection over 1 minute followed by double flushing of the 10 mL syringe and IV with saline. Eighty (80) procedures was used to investigate variations in the activity from the amount prescribed (µCi) = 1.35 × Patient weight Kg. The Activity dispensed into a 10mL syringe using a NIST traceable Capintec CRC-25R Chamber and a cross calibrated capintec CRC-15R to measure activity in the syringe immediately before and after administration Results: The patients weight range from 121Ib to 235lb and doses ranging 74.25 µCi to 144.2 µCi. The deviation of dispensed dose vs Prescribed dose average +2.1% with a range of −1.1% to +5.7%. The Dose measured before administration ranges 79.3 µCi to 154.9 µCi. Deviation from the dispensed dose was show to average +2.9% with a range of −0.8% to +7.3%. The average residual dose post injection was 2.5 µCi or 2.2% of the pre injection activity. Ranging from 0.9 µCi to 6.2 µCi, 0.7% to 5.4% respectively. Subtracting the residual activity from that measured activity before injection and comparing it to prescription dose was shown to have an average variation of +2.7% with a range of −0.8% to 7.4%. Conclusion: The case resulted in the 6.2 µCi maximum residual dose had two syringes. A small, 82.8 µCi activity, case resulted in the 7.4% maximum variation in measures less residual verses prescription dose. The average +2.1 % dispenses activity of Ra 223 over the prescription dosage was seen to counteract the average 2.2% residual dosage found to remain in the syringe.

  4. Economic and utilitarian benefits of monetary versus non-monetary in-store sales promotions

    DEFF Research Database (Denmark)

    Reid, Mike; Thompson, Peter; Mavondo, Felix

    2014-01-01

    While prior research has examined the issue of sales promotion proneness, very little has examined proneness to non-monetary promotions, such as contests and premiums discovered in store. This study draws on a promotions benefits framework to examine the influence of shoppers’ desired benefits...... are that many monetary sales promotion-prone shoppers may be attracted by the benefits provided by non-monetary promotions. The increased use by managers of non-monetary promotions instead of monetary promotions may result in improved category value and brand equity benefits....

  5. Potential of prescription registries to capture individual-level use of aspirin and other nonsteroidal anti-inflammatory drugs in Denmark: trends in utilization 1999-2012

    DEFF Research Database (Denmark)

    Schmidt, M.; Hallas, J.; Friis, S.

    2014-01-01

    according to NSAID subtype was observed; ibuprofen use increased, use of all newer selective cyclooxygenase-2 inhibitors nearly ceased after 2004, diclofenac use decreased by nearly 50% after 2008, and naproxen use remained stable. As of 2012, the prescribed proportion of individual-level NSAID sales was 92...... and to quantify the proportion of total sales that was sold on prescription. METHOD: Based on nationwide data from the Danish Serum Institute and the Danish National Prescription Registry, we retrieved sales statistics for the Danish primary health care sector to calculate 1-year prevalences of prescription users...... of aspirin or nonaspirin NSAIDs, and to estimate the corresponding proportions of total sales dispensed on prescription. RESULTS: Both low-dose aspirin and nonaspirin NSAIDs were commonly used in the Danish population between 1999 and 2012, particularly among elderly individuals. The 1-year prevalence...

  6. Community syringe collection and disposal policies in 16 states.

    Science.gov (United States)

    Turnberg, Wayne L; Jones, T Stephen

    2002-01-01

    To review laws, regulations, and guidelines that affect the collection and disposal of hypodermic needles, syringes, and lancets used outside of professional health care settings (hereafter referred to as "community syringes"). Law and policy analysis. Alabama, California, Florida, Georgia, Hawaii, Massachusetts, Michigan, Minnesota, New Jersey, New York, Ohio, Oregon, Rhode Island, South Carolina, Washington, and Wisconsin. Information on syringe collection and disposal in the community was gathered from federal and state records and state agency personnel. Legally permissible means of syringe collection and disposal available to persons in the community injecting medical treatments and injection drug users. Laws, regulations, or guidelines in 13 states allowed community syringes to be legally discarded in household trash; guidelines for in-trash disposal varied among the states. Only 6 states had laws or regulations that specifically addressed community syringe collection. In 10 states, infectious waste laws and regulations that apply to medical facilities such as clinics would also apply to community syringe collection sites. In the 16 states studied, laws, regulations, and guidelines relating to community syringe collection and disposal were somewhat inconsistent and confusing and presented potential barriers to safe disposal. States should consider amending laws, regulations, and guidelines to promote community syringe collection programs. A national effort is needed to achieve consistent community syringe collection and disposal laws and guidelines for all states. Pharmacists can aid in safe syringe disposal by counseling their patients about safe disposal, providing or selling sharps containers, and accepting used syringes for safe disposal. Pharmacists can join other interested groups in advocating clarification of disposal laws and regulations that favor community programs designed to keep syringes out of the trash so that they can be disposed of as

  7. Development of Syringe/Bottle Hybrids for Sampling Slurries

    International Nuclear Information System (INIS)

    Coleman, C.J.

    1998-01-01

    A convenient and effective sample bottle system based on simple modifications of disposable plastic syringes and bottles has been devised and tested for slurry samples. Syringe/ bottle hybrids (hereafter referred to as syringe bottles) have the convenience of regular flat-bottom bottles with screw cap closures. In addition, the syringe imparts a sliding and adjustable bottom to the bottle that forces the entire contents from the bottle. The system was designed especially to collect samples for high temperature work-ups of DWPF slurry samples. The syringe bottles together with fixed-bottom sample vial inserts would provide the DWPF with convenient and reliable methods for dealing with slurry samples

  8. Reducing inappropriate non-steroidal anti-inflammatory prescription in primary care patients with chronic kidney disease.

    Science.gov (United States)

    Keohane, David M; Dennehy, Thomas; Keohane, Kenneth P; Shanahan, Eamonn

    2017-08-14

    Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor. This group was refined to include those with an estimated glomerular filtration rate (eGFR)<60 ml/min per 1.73m2 (stage 3 CKD or greater). Phase one analysed how many prescriptions had occurred in this group over the preceding three months. The intervention involved creating an automated alert on at risk patient records if non-steroidal anti-inflammatories were prescribed and discussing the rationale with practice staff. The re-audit phase occurred three months' post intervention. Findings The study revealed 728/7,500 (9.7 per cent) patients at risk from CKD and 158 (2.1 per cent) who were subsequently found to have an eGFR<60 ml/min, indicating=stage 3 CKD. In phase one, 10.2 per cent of at risk patients had received a non-steroidal anti-inflammatory prescription in the preceding three months. Additionally, 6.2 per cent had received non-steroidal anti-inflammatories on repeat prescription. Phase two post intervention revealed a significant 75 per cent reduction in the total non-steroidal anti-inflammatories prescribed and a 90 per cent reduction in repeat non-steroidal anti-inflammatory prescriptions in those with CKD. Originality/value The study significantly reduced non-steroidal anti-inflammatory prescription in those with CKD in primary care settings. It also created a CKD register within the practice and an enduring medication alert system for individuals that risk nephrotoxic

  9. 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.

  10. 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

  11. Open-Source Syringe Pump Library

    Science.gov (United States)

    Wijnen, Bas; Hunt, Emily J.; Anzalone, Gerald C.; Pearce, Joshua M.

    2014-01-01

    This article explores a new open-source method for developing and manufacturing high-quality scientific equipment suitable for use in virtually any laboratory. A syringe pump was designed using freely available open-source computer aided design (CAD) software and manufactured using an open-source RepRap 3-D printer and readily available parts. The design, bill of materials and assembly instructions are globally available to anyone wishing to use them. Details are provided covering the use of the CAD software and the RepRap 3-D printer. The use of an open-source Rasberry Pi computer as a wireless control device is also illustrated. Performance of the syringe pump was assessed and the methods used for assessment are detailed. The cost of the entire system, including the controller and web-based control interface, is on the order of 5% or less than one would expect to pay for a commercial syringe pump having similar performance. The design should suit the needs of a given research activity requiring a syringe pump including carefully controlled dosing of reagents, pharmaceuticals, and delivery of viscous 3-D printer media among other applications. PMID:25229451

  12. [Prescription, dispensing, and regulation of psychoactive anorexigenic drugs in Belo Horizonte, Minas Gerais, Brazil].

    Science.gov (United States)

    Carneiro, Mônica de Fátima Gontijo; Guerra, Augusto Afonso; Acurcio, Francisco de Assis

    2008-08-01

    This retrospective study in Belo Horizonte, Minas Gerais, Brazil, aimed to provide indicators on the sale and consumption of anorexigenic substances. During the first stage, 2,906 of 168,237 prescriptions received by pharmacies in 2003 were analyzed, showing low quality of prescriptions. Projected consumption in defined daily doses was 19.75 DDD/1,000 inhabitants/day in 2003. Fenproporex (59.8%) was the most widely consumed drug. One pharmacy was responsible for 39.8% of the pharmaceutical sales. During the second stage, 14,554 sales records from this "blockbuster" pharmacy were analyzed, from April to August 2005; 9.2% of sales were for anorexigenic products, 91.8% of which prescribed in association with another substance. The data suggest irrational use of anorexigenic drugs by these consumers and highlight the need for proper regulation of these products. It is important to understand both the role of pharmacies in this regulation and that of physicians in the rational use of these substances.

  13. Botulinum Toxin Therapy: Is Syringe Type Related to Cost-Effectiveness?

    Science.gov (United States)

    Foglietti, Mark Anthony; Wright, Lauren; Foglietti-Fostyk, Alanna

    2018-03-01

    Clostridium botulinum toxin is effective through cleaving presynaptic proteins at the neuromuscular junction, which prevents the release of acetylcholine and inhibits muscle contraction. Several serotypes of botulinum toxin (BT) exist; however, only 2 types have been approved by the US Food and Drug Administration for commercial and medical use, A and B. Both types of BT must be administered intramuscularly with a syringe, but the type of syringe is the injector's preference. Which syringe type is most efficient in minimizing product waste and most cost-effective for the patient and provider? We performed a single-center, open-label, analytical study using BT therapy and 2 types of syringes for analytics of cost-effectiveness. OnabotulinumtoxinA was the neuromodulator used in this report. Vials (100 U) of BT A were each reconstituted with 2.5 mL of 0.9% sodium chloride, for a final concentration of 4 U/0.1 mL. High-dead-space syringes are compared with low-dead-space syringes: 1-mL tuberculin (TB) luer slip syringe with detachable 25-gauge needle and 1-mL ultrafine insulin syringe with an attached 31-gauge needle, respectively. After each syringe was evacuated, the TB syringe was noted to contain 0.05 mL of the remaining product in the hub. Providers are discarding approximately 2 U of BT per TB syringe product injection. If the physician uses 30 syringes per day, 3 days a week, for 1 year, it equals to a lost revenue of approximately $155,500 per year. To individualize the cost-effective analysis, average quantity of syringes used per patient and overall patient volume must be considered, with corresponding adjustment of cost and units discarded. The American Society of Plastic Surgeons reported that the use of neuromodulators has increased by approximately 797% from 2000 to 2016. During that period, the price of neuromodulators has also increased by approximately 85%. Considering these statistics, the type of syringe used for BT neuromodular injection is a

  14. Combination syringe provides air-free blood samples

    Science.gov (United States)

    Pool, S. L.

    1970-01-01

    Standard syringe and spinal needle are combined in unique manner to secure air-free blood samples. Combination syringe obtains air free samples because air bubbles become insignificant when samples greater than 1 cc are drawn.

  15. Multifaceted determinants of online non-prescription drug information seeking and the impact on consumers' use of purchase channels.

    Science.gov (United States)

    Holtgräfe, Catherine; Zentes, Joachim

    2012-06-01

    The growing importance of the Internet as an information and purchasing channel is drawing widespread attention from marketing decision makers. Nevertheless, the relevance of the Internet to the so-called self-medication market in Germany has been paid barely enough attention. Our study aims to contribute insights concerning the penetration of the Internet in this market, as well as to give an overview of the critical determinants of Internet use for non-prescription drug information seeking, such as the accessibility of professional information, trust in health professionals' opinion and the ability to search online, as well as the perceived usefulness and credibility of online non-prescription drug information. Furthermore, we demonstrate that the preferred use of the Internet as a non-prescription drug information source positively influences the choice of unconventional purchase channels for non-prescription drugs and negatively affects the use of stationary pharmacies.

  16. The effectiveness and safety of syringe vending machines as a component of needle syringe programmes in community settings.

    Science.gov (United States)

    Islam, Mofizul; Wodak, Alex; Conigrave, Katherine M

    2008-12-01

    Syringe vending machines (SVMs) have been introduced in Europe and Australasia as part of the effort to increase the availability of sterile needles and syringes to injecting drug users (IDUs). This qualitative review of 14 published and grey literature studies examines whether community-based SVMs as a component of a comprehensive needle syringe programme (NSP) assist to reduce the spread of HIV and other blood-borne viruses amongst IDUs. The available evidence suggests that SVMs increase access to sterile injecting equipment, reduce needle and syringe sharing, and are likely to be cost efficient. SVMs also complement other modes of NSP delivery as they are used by IDUs who are less likely to attend staffed NSPs or pharmacies. If installed and properly maintained in a well-chosen location and with the local community well prepared, SVMs can enhance the temporal and geographical availability of sterile injecting equipment.

  17. [Morphine self-administration by rats using a pneumatic syringe].

    Science.gov (United States)

    Akiyama, Y; Takayama, S

    1988-06-01

    An apparatus for drug self-administration by rats using a pneumatic syringe was developed by Weeks. A microliter syringe operated by a pneumatic cylinder supplies an accurate volume of drug solution within one second. When coefficient of variation of infusion volume was compared among pneumatic syringe, infusion pump, and peristaltic pump, pneumatic syringe showed higher accuracy in infusion volume than the other two pumps. Since the infusion speed by a pneumatic syringe is very rapid (less than one second per infusion), the effect of infusion speed on reinforcing property of morphine was investigated. When rats self-administered 0.1, 0.3, 1.0, and 3.0 mg/kg/infusion of morphine by pneumatic syringes, the patterns of self-infusion were more stable, the number of self-infusions and the amount self-administered were larger, and a dose-response relationship was clearer in comparison with those self-infused the same doses of morphine for 5.6 seconds by infusion pumps or peristaltic pumps.

  18. Non-prescription medicines: a process for standards development and testing in community pharmacy.

    Science.gov (United States)

    Benrimoj, Shalom Charlie I; Gilbert, Andrew; Quintrell, Neil; Neto, Abilio C de Almeida

    2007-08-01

    The objective of the study was to develop and test standards of practice for handling non-prescription medicines. In consultation with pharmacy registering authorities, key professional and consumer groups and selected community pharmacists, standards of practice were developed in the areas of Resource Management; Professional Practice; Pharmacy Design and Environment; and Rights and Needs of Customers. These standards defined and described minimum professional activities required in the provision of non-prescription medicines at a consistent and measurable level of practice. Seven standards were described and further defined by 20 criteria, including practice indicators. The Standards were tested in 40 community pharmacies in two States and after further adaptation, endorsed by all Australian pharmacy registering authorities and major Australian pharmacy and consumer organisations. The consultation process effectively engaged practicing pharmacists in developing standards to enable community pharmacists meet their legislative and professional responsibilities. Community pharmacies were audited against a set of standards of practice for handling non-prescription medicines developed in this project. Pharmacies were audited on the Standards at baseline, mid-intervention and post-intervention. Behavior of community pharmacists and their staff in relation to these standards was measured by conducting pseudo-patron visits to participating pharmacies. The testing process demonstrated a significant improvement in the quality of service delivered by staff in community pharmacies in the management of requests involving non-prescription medicines. The use of pseudo-patron visits, as a training tool with immediate feedback, was an acceptable and effective method of achieving changes in practice. Feedback from staff in the pharmacies regarding the pseudo-patron visits was very positive. Results demonstrated the methodology employed was effective in increasing overall

  19. Pill-poppers and dopers: a comparison of non-medical prescription drug use and illicit/street drug use among college students.

    Science.gov (United States)

    Ford, Jason A; Arrastia, Meagan C

    2008-07-01

    Data from the 2001 College Alcohol Study, a national sample of U.S. college students, were used to conduct multinomial logistic regression analysis examining correlates of substance use. Students were divided into three groups based on their lifetime substance use: non-users, non-medical prescription drug use only, and illicit/street drug use only. The purpose of this analytic strategy was to examine the similarities/differences in the correlates of non-medical prescription drug use and illicit/street drug use. Findings indicate that race, age, G.P.A., sexual activity, health, binge drinking, marijuana use, social bonding and social learning measures are correlates of non-medical prescription drug use. Correlates of illicit/street drug use include gender, Hispanic ethnicity, sexual activity, binge drinking, marijuana use, social bonding and social learning measures. Finally, the focus of the paper is a comparison of students who report only non-medical prescription drug use to students who report only illicit/street drug use. Findings indicate that gender, race, marital status, sexual activity, marijuana use, and social bonding measures significantly distinguish illicit/street drug use from non-medical prescription drug use. Important implications, limitations, and future research needs were discussed.

  20. 76 FR 41434 - Removal of Certain Requirements Related to the Prescription Drug Marketing Act; Opportunity for...

    Science.gov (United States)

    2011-07-14

    .... FDA-2011-N-0446] Removal of Certain Requirements Related to the Prescription Drug Marketing Act... Food and Drug Administration (FDA) is proposing to remove a section of the Prescription Drug Marketing... prior sale, purchase, or trade of such drug,'' starting with the manufacturer, and that the identifying...

  1. Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange.

    Science.gov (United States)

    De, Prithwish; Cox, Joseph; Boivin, Jean-François; Platt, Robert W; Jolly, Ann M

    2008-01-01

    Secondary syringe exchange (SSE) refers to the exchange of sterile syringes between injection drug users (IDUs). To date there has been limited examination of SSE in relation to the social networks of IDUs. This study aimed to identify characteristics of drug injecting networks associated with the receipt of syringes through SSE. Active IDUs were recruited from syringe exchange and methadone treatment programs in Montreal, Canada, between April 2004 and January 2005. Information on each participant and on their drug-injecting networks was elicited using a structured, interviewer-administered questionnaire. Subjects' network characteristics were examined in relation to SSE using regression models with generalized estimating equations. Of 218 participants, 126 were SSE recipients with 186 IDUs in their injecting networks. The 92 non-recipients reported 188 network IDUs. Networks of SSE recipients and non-recipients were similar with regard to network size and demographics of network members. In multivariate analyses adjusted for age and gender, SSE recipients were more likely than non-recipients to self-report being HIV-positive (OR=3.56 [1.54-8.23]); require or provide help with injecting (OR=3.74 [2.01-6.95]); have a social network member who is a sexual partner (OR=1.90 [1.11-3.24]), who currently attends a syringe exchange or methadone program (OR=2.33 [1.16-4.70]), injects daily (OR=1.77 [1.11-2.84]), and shares syringes with the subject (OR=2.24 [1.13-4.46]). SSE is associated with several injection-related risk factors that could be used to help focus public health interventions for risk reduction. Since SSE offers an opportunity for the dissemination of important prevention messages, SSE-based networks should be used to improve public health interventions. This approach can optimize the benefits of SSE while minimizing the potential risks associated with the practice of secondary exchange.

  2. Illicit drug use is increasing among non-medical users of prescription drugs-Results from population-based surveys 2002-2014.

    Science.gov (United States)

    Karjalainen, Karoliina; Lintonen, Tomi; Hakkarainen, Pekka

    2017-09-01

    Non-medical use of prescription drugs (NMUPD) is known to be associated with illicit drug use, but less is known about how illicit drug use has changed in NMUPD. We examined (1) the changes in illicit drug use among Finnish non-medical users of prescription drugs during the 2000s and (2) whether the trends of illicit drug use differ by non-medical use of prescription drugs in the general population. Data were derived from population-based (aged 15-69) Drug Surveys conducted in Finland in 2002, 2006, 2010 and 2014. The response rates varied between 63% and 48%. NMUPD during the last year was measured (n=252). Past-year illicit drug use among non-medical users of prescription drugs and the reference population not reporting NMUPD (n=10,967) was compared. Logistic regression was used to estimate the p-values for trends. Illicit drug use has increased notably among Finnish non-medical users of prescription drugs (from 21% to 70%, p for trendillicit drug use also increased statistically significantly, but much more moderately (from 2.5% to 5.4%). The difference between the trends was confirmed by an interaction test (p=0.022). NMUPD seems to be increasingly merging with illicit drug use. This indicates an increasing prevalence of polydrug use among non-medical users of prescription drugs, which may bring about more severe harms and worse health outcomes for users and more challenges in regard to treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Malaria healthcare policy change in Kenya: implications on sales and marketing of antimalarials.

    Science.gov (United States)

    Ngure, Peter K; Nyaoke, Lorraine; Minja, David

    2012-03-01

    Malaria healthcare policy change in Kenya aimed at improving the control of malaria but faced a number of challenges in implementation related to marketing of the drugs. This research investigated the effect of the change of the national malaria policy on drug sales and strategic marketing responses of antimalarial pharmaceutical companies in Kenya. A descriptive cross-sectional design was employed to describe the existing state of antimalarials market in Kenya after the change of the malaria healthcare policy. Policy change did result in an increase in the sales of Coartem®. Novartis Pharma recorded a 97% growth in sales of Coartem® between 2003 and 2004. However, this increase was not experienced by all the companies. Further, SPs (which had been replaced as first-line therapy for malaria) registered good sales. In most cases, these sales were higher than the sales of Coartem®. Generally, the sales contribution of SPs and generic antimalarial medicines exceeded that of Coartem® for most distributors. The most common change made to marketing strategies by distributors (62.5%) was to increase imports of antimalarials. A total of 40% of the manufacturers preferred to increase their budgetary allocation for marketing activities. In view of the fact that continued sale of SP drugs and limited availability of AL poses the risk of increasing the incidence of malaria in Kenya, it is therefore, recommended that pharmacy surveillance systems be strengthened to ensure drugs that have been rendered non-viable or that prescription-only medicines are not sold contrary to the national guidelines.

  4. Non-destructive vacuum decay method for pre-filled syringe closure integrity testing compared with dye ingress testing and high-voltage leak detection.

    Science.gov (United States)

    Simonetti, Andrea; Amari, Filippo

    2015-01-01

    solution, preventing possible prefilled syringe plunger movement during container closure integrity testing execution, is presented as well. The growing need to meet sterile drug products' regulatory, quality, and safety expectations has progressively driven new developments and improvements both in container closure integrity testing methods and in the respective equipment, over the last years. Indeed, container closure integrity testing establishes the container closure system capability to provide required protection to the drug product and to demonstrate maintenance of product sterility over its shelf life. This article describes the development of four container closure integrity testing approaches for the evaluation of glass prefilled syringe closure integrity, including two destructive (pharmacopoeial and Novartis specific dye ingress test) and two non-destructive (vacuum decay and high-voltage leak detection) methods. The important finding from the validation of comparative studies was that the vacuum decay method resulted in the most effective, reliable and repeatable detection of defective samples, whether the defect was exposed to sterile water, to drug product, or to air. Complete sets of known defects were created for this purpose (5 μm, 10 μm, 20 μm certified leakages by laser drilled holes and capillary tubes). All investigations and studies were conducted at Bonfiglioli Engineering S.r.l. (Vigarano Pieve, Ferrara, Italy) and at Novartis Vaccines (Sovicille, Siena, Italy). © PDA, Inc. 2015.

  5. Retention and variability of hydrogen (H2) samples stored in plastic syringes

    DEFF Research Database (Denmark)

    Rumessen, J J; Gudmand-Høyer, E

    1987-01-01

    The utility of two brands of 20 ml plastic syringes for storage of hydrogen (H2) samples as obtained in H2 breath tests were studied. Plastipak syringes were found to be significantly better with regard to the stability of the H2 concentration and the variability between the H2 samples. Storage...... of the H2 samples in Plastipak syringes at 5 degrees C significantly improved the H2 retention, whereas refrigeration of H2 samples stored in Once syringes did not reduce H2 loss. Storage of H2 samples in refrigerated plastic syringes is efficient and reliable for several days if syringes with minimal...... sample variation are used....

  6. Drug residues in used syringes in Switzerland: A comparative study.

    Science.gov (United States)

    Lefrançois, Elodie; Augsburger, Marc; Esseiva, Pierre

    2018-05-01

    Harm reduction services, including needle-exchange programmes, have been implemented in Switzerland for over 20 years. Their main aim is to lessen the negative social and/or physical consequences associated with illicit drug consumption and, therefore, improve prevention messages. To this end, knowledge of illicit drug consumption practices is necessary. Periodic self-report surveys are the primary source of data for monitoring drug users' behaviour. Analysis of residual content of used syringes can bring further and objective knowledge about consumed products through analytically confirmed data. Used syringes were sampled in 2 syringe-exchange facilities in Lausanne. These structures are a bus where the users bring back their syringes (ABS) and an automatic injecting kit dispenser (AIKD). Once syringes were collected, a validated gas chromatography-mass spectrometry (GC-MS) method was implemented in order to detect drugs (licit or illicit) contained in the residual content of used syringes. Cocaine was the most common drug detected alone (39% in ABS and 31% in AIKD), followed by the simultaneous detection of heroin and cocaine (12% and 17%) and heroin and midazolam (12% and 17%). The differences between the illicit drugs distribution of used syringes collected in AIKD and ABS were not statistically significant. Analysis of residual content of used syringes as a monitoring tool is an original approach that has already led to a better understanding of the habits of drug-injection users. Over the long term, this approach is a powerful tool to track and detect new consumption practices in a quasi-real-time. Copyright © 2017 John Wiley & Sons, Ltd.

  7. The provision of non-needle/syringe drug injecting paraphernalia in the primary prevention of HCV among IDU: a systematic review

    Directory of Open Access Journals (Sweden)

    Ahmed Syed

    2010-11-01

    Full Text Available Abstract Background Sharing drug injecting paraphernalia other than needles and syringes (N/S has been implicated in the transmission of Hepatitis C virus (HCV among injecting drug users (IDU. We aimed to determine whether the provision of sterile non-N/S injecting paraphernalia reduces injecting risk behaviours or HCV transmission among IDU. Methods A systematic search of seven databases and the grey literature for articles published January 1989-February 2010 was undertaken. Thirteen studies (twelve observational and one non-randomized uncontrolled pilot intervention were identified and appraised for study design and quality by two investigators. Results No studies examined the association between the provision of non-N/S injecting paraphernalia and incident HCV infection. One cross-sectional study found that individuals who frequently, compared to those who infrequently, used sterile cookers and water, were less likely to report prevalent HCV infection. Another found no association between the uptake of sterile non-N/S injecting paraphernalia and self-reported sharing of this paraphernalia. The remaining observational studies used attendance at needle and syringe exchange programmes (NSP or safer injection facilities (SIF that provided non-N/S injecting paraphernalia as a proxy measure. Eight studies presented adjusted odds ratios, ranging from 0.3 to 0.9, suggesting a reduced likelihood of self-reported sharing of non-N/S injecting paraphernalia associated with use of NSP or SIF. There was substantial uncertainty associated with these estimates however. Three unadjusted studies reported a reduction in the prevalence of sharing of non-N/S injecting paraphernalia over time among NSP users. Only one study reported an adjusted temporal trend in the prevalence of sharing non-N/S injecting paraphernalia, finding higher rates among non-NSP users than NSP users at each time point, and a greater reduction in sharing among non-NSP than NSP users over

  8. Sales impact of displaying alcoholic and non-alcoholic beverages in end-of-aisle locations: an observational study.

    Science.gov (United States)

    Nakamura, Ryota; Pechey, Rachel; Suhrcke, Marc; Jebb, Susan A; Marteau, Theresa M

    2014-05-01

    In-store product placement is perceived to be a factor underpinning impulsive food purchasing but empirical evidence is limited. In this study we present the first in-depth estimate of the effect of end-of-aisle display on sales, focussing on alcohol. Data on store layout and product-level sales during 2010-11 were obtained for one UK grocery store, comprising detailed information on shelf space, price, price promotion and weekly sales volume in three alcohol categories (beer, wine, spirits) and three non-alcohol categories (carbonated drinks, coffee, tea). Multiple regression techniques were used to estimate the effect of end-of-aisle display on sales, controlling for price, price promotion, and the number of display locations for each product. End-of-aisle display increased sales volumes in all three alcohol categories: by 23.2% (p = 0.005) for beer, 33.6% (p sales of alcohol and non-alcoholic beverages. Restricting the use of aisle ends for alcohol and other less healthy products might be a promising option to encourage healthier in-store purchases, without affecting availability or cost of products. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Ranking the harm of non-medically used prescription opioids in the UK

    NARCIS (Netherlands)

    van Amsterdam, Jan; Phillips, Lawrence; Henderson, Graeme; Bell, James; Bowden-Jones, Owen; Hammersley, Richard; Ramsey, John; Taylor, Polly; Dale-Perera, Annette; Melichar, Jan; van den Brink, Wim; Nutt, David

    2015-01-01

    A panel of nine experts applied multi-criteria decision analysis (MCDA) to determine the relative overall harm to users and harms to others of street heroin (injected and smoked) and eleven non-medically used prescription opioids. The experts assessed harm scores for each of the 13 opioids on each

  10. Social-structural contexts of needle and syringe sharing behaviours of HIV-positive injecting drug users in Manipur, India: a mixed methods investigation

    Directory of Open Access Journals (Sweden)

    Shunmugam Murali

    2011-05-01

    Full Text Available Abstract Background Few investigations have assessed risk behaviours and social-structural contexts of risk among injecting drug users (IDUs in Northeast India, where injecting drug use is the major route of HIV transmission. Investigations of risk environments are needed to inform development of effective risk reduction interventions. Methods This mixed methods study of HIV-positive IDUs in Manipur included a structured survey (n = 75, two focus groups (n = 17, seven in-depth interviews, and two key informant interviews. Results One-third of survey participants reported having shared a needle/syringe in the past 30 days; among these, all the men and about one-third of the women did so with persons of unknown HIV serostatus. A variety of social-structural contextual factors influenced individual risk behaviours: barriers to carrying sterile needles/syringes due to fear of harassment by police and "anti-drug" organizations; lack of sterile needles/syringes in drug dealers' locales; limited access to pharmacy-sold needles/syringes; inadequate coverage by needle and syringe programmes (NSPs; non-availability of sterile needles/syringes in prisons; and withdrawal symptoms superseding concern for health. Some HIV-positive IDUs who shared needles/syringes reported adopting risk reduction strategies: being the 'last receiver' of needles/syringes and not a 'giver;' sharing only with other IDUs they knew to be HIV-positive; and, when a 'giver,' asking other IDUs to wash used needles/syringes with bleach before using. Conclusions Effective HIV prevention and care programmes for IDUs in Northeast India may hinge on several enabling contexts: supportive government policy on harm reduction programmes, including in prisons; an end to harassment by the police, army, and anti-drug groups, with education of these entities regarding harm reduction, creation of partnerships with the public health sector, and accountability to government policies that protect IDUs

  11. Commentary on Vorobjov et al., "Comparison of injection drug users who obtain syringes from pharmacies and syringe exchange programs in Tallinn, Estonia"

    Directory of Open Access Journals (Sweden)

    Werb Daniel

    2009-01-01

    Full Text Available Abstract Recent data suggest that globally, between 5% and 10% of all new HIV cases are the result of unsafe injecting practices, and experts agree that reducing these practices is key to tackling the spread of HIV. And yet, despite the overwhelming evidence that providing sterile syringes to injection drug users (IDU through syringe exchange programs (SEPs or other means is an effective way of reducing HIV transmission among high-risk subpopulations, IDU in most settings still do not have access to sterile injecting equipment or if they do, access remains too restricted to effectively reduce the risk of HIV transmission. Vorobjov and colleagues have presented in this journal an interesting and timely study from Estonia comparing individuals who obtain syringes from SEPs and those who obtain syringes from pharmacies. As the authors point out, Estonia faces an unacceptably high HIV incidence rate of 50 new HIV cases per 100,000, this rate driven primarily by injection drug use. As such, the authors argue that Estonia's SEP network does not have the capacity to serve a growing IDU population at risk of transmitting HIV and pharmacy dispensation of clean syringes may be one potential approach to decreasing syringe sharing among high-risk injectors. It may be overly optimistic to consider the impact of higher threshold interventions such as pharmacy-based SEPs, given that IDU populations that engage in HIV risk behaviours such as syringe sharing are often hidden or hard to reach. Despite the need for a cautious approach, however, the findings presented by Vorobjov et al. may chart one potential course towards a more comprehensive societal response to reducing the health harms associated with injection drug use.

  12. 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.

  13. Options for reducing HIV transmission related to the dead space in needles and syringes.

    Science.gov (United States)

    Zule, William A; Pande, Poonam G; Otiashvili, David; Bobashev, Georgiy V; Friedman, Samuel R; Gyarmathy, V Anna; Des Jarlais, Don C

    2018-01-15

    When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.

  14. A descriptive study of chiropractors' opinions and practices regarding office-based health product sales

    Directory of Open Access Journals (Sweden)

    Page Stacey A

    2012-04-01

    Full Text Available Abstract Background Although the sale of non-prescription health products is ubiquitous, the views of health professionals, such as chiropractors, regarding the sale of such products are not well known. Practitioner opinion is important to understand and inform professional practice. The purpose of this study was to describe chiropractors' perspectives and practices on the sale of health care products from practitioners' offices. Methods Chiropractors were invited to provide written comments about health product sales at the end of a fixed choice, mailed survey. Respondents' comments were analyzed using qualitative description. Ethics approval was received from the Conjoint Health Research Ethics Board at the University of Calgary. Results One hundred seven of the 265 respondents (response rate of 51% provided written comments. Approximately 30 pages of double-spaced, typed text were gathered. Respondents did not consistently endorse or condemn health product sales, and engaged in the practice to greater and lesser extents. While some were opposed to health products sales, some accepted the practice with a degree of ambivalence whereas others clearly embraced it. Some respondents acknowledged a professional conflict of interest in such sales and marketing, and described strategies used to mitigate it. Others provided a range of justifications for the practice. Personal integrity and professional standards were discussed and a need for monitoring identified. Conclusions A wide range of opinions and practices were described and this is consistent with resulting variation in practice. In light of this, standards that facilitate consistency in practice may benefit professionals and the public alike.

  15. The Washington Needle Depot: fitting healthcare to injection drug users rather than injection drug users to healthcare: moving from a syringe exchange to syringe distribution model

    Directory of Open Access Journals (Sweden)

    Glickman Andrea

    2010-01-01

    Full Text Available Abstract Needle exchange programs chase political as well as epidemiological dragons, carrying within them both implicit moral and political goals. In the exchange model of syringe distribution, injection drug users (IDUs must provide used needles in order to receive new needles. Distribution and retrieval are co-existent in the exchange model. Likewise, limitations on how many needles can be received at a time compel addicts to have multiple points of contact with professionals where the virtues of treatment and detox are impressed upon them. The centre of gravity for syringe distribution programs needs to shift from needle exchange to needle distribution, which provides unlimited access to syringes. This paper provides a case study of the Washington Needle Depot, a program operating under the syringe distribution model, showing that the distribution and retrieval of syringes can be separated with effective results. Further, the experience of IDUs is utilized, through paid employment, to provide a vulnerable population of people with clean syringes to prevent HIV and HCV.

  16. Safe and unsafe spaces: Non-fatal overdose, arrest, and receptive syringe sharing among people who inject drugs in public and semi-public spaces in Baltimore City.

    Science.gov (United States)

    Hunter, Kyle; Park, Ju Nyeong; Allen, Sean T; Chaulk, Patrick; Frost, Taeko; Weir, Brian W; Sherman, Susan G

    2018-04-13

    The spaces in which drug use occurs constitutes a key aspect of the "risk environment" of people who inject drugs (PWID). We aimed to add nuance to the characterization of "safe" and "unsafe" spaces in PWID's environments to further understand how these spaces amplify the risk of morbidities associated with injection drug use. PWID were recruited through the Baltimore City syringe service program and through peer referral. Participants completed a socio-behavioral survey. Multivariable logistic regression was used to identify associations between utilization of public, semi-public and private spaces with arrest, non-fatal overdose, and receptive syringe sharing. The sample of PWID (N = 283) was mostly 45 years and older (54%), male (69%), Black (55%), and heroin users (96%). Compared to PWID who primarily used private settings, the adjusted odds of recent overdose were greater among PWID who mostly used semi-public and public locations to inject drugs. We also found independent associations between arrest and semi-public spaces, and between receptive syringe sharing and public spaces (all p spaces where PWID can reduce their risk of overdose, likelihood of arrest and blood-borne diseases, and the dual potential of the environment in promoting health and risk. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. 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...

  18. Efficacy trial of Camouflage Syringe to reduce dental fear and anxiety.

    Science.gov (United States)

    Ujaoney, S; Mamtani, M; Thakre, T; Tote, J; Hazarey, V; Hazarey, P; Kulkarni, H

    2013-12-01

    Dental fear and anxiety in early childhood are widely prevalent and contribute to dental problems and behaviour in adulthood. Novel ways to reduce dental fear and anxiety in children are needed. Our aim was to conduct an efficacy trial of a novel Camouflage Syringe to reduce dental fear and anxiety in children. randomised controlled trial of efficacy of the Camouflage Syringe. We designed a Camouflage Syringe with a toy-like appearance that veils the conventional syringe to permit topical application and injection of local anaesthesia and ensure more involvement of the patient in the treatment process. We conducted a concurrent parallel, randomised controlled trial (NCT01398007) on the efficacy of this Camouflage Syringe to reduce the dental fear and anxiety in children seeking dental treatment who required the use of local anaesthesia. Using Venham's clinical rating scale, Venham's picture test, parental stress questionnaire and recall questionnaire, the efficacy of the Camouflage Syringe to reduce dental fear and anxiety ranged from 82% to 97% for various outcomes and from 60% to 100% for prevention of related adverse outcomes. For all outcomes, the number needed to treat was close to unity. Our results strongly favour the use of Camouflage Syringe to reduce dental fear and anxiety in children.

  19. 76 FR 55835 - Non-Face-to-Face Sale and Distribution of Tobacco Products and Advertising, Promotion, and...

    Science.gov (United States)

    2011-09-09

    ... Advertising, Promotion, and Marketing of Tobacco Products AGENCY: Food and Drug Administration, HHS. ACTION...-to-face sale and distribution of tobacco products and the advertising, promotion, and marketing of... information related to non-face-to-face sale and distribution of tobacco products; the advertising, promotion...

  20. The use of non-prescription medicines during lactation: A qualitative study of community pharmacists' attitudes and perspectives.

    Science.gov (United States)

    Sim, Tin Fei; Hattingh, H Laetitia; Sherriff, Jillian; Tee, Lisa B G

    2018-05-01

    Community pharmacists play a significant role in the provision of non-prescription medicines. There is evidence that women self-medicate and use non-prescription medicines whilst breastfeeding. Studies have demonstrated that breastfeeding women are likely to seek advice from pharmacists, presenting a unique opportunity for pharmacists to provide on-going support of these women especially in relation to the appropriate use of non-prescription medicines. This study aimed to explore community pharmacists' attitudes and perspectives towards the use of non-prescription medicines during breastfeeding. This exploratory study was conducted through semi-structured interviews with 30 community pharmacists in Western Australia, between July and September 2013. Transcribed data were analysed using descriptive and qualitative approaches. NVivo ® Version 10.0 was used to organise qualitative data and quotations to facilitate thematic analysis. Four major themes emerged. Despite the positive attitudes and favourable perceived knowledge level, participants often found themselves in a dilemma when required to make clinical recommendations especially in situations where there was a therapeutic need for treatment but clear guidelines or evidence to suggest safety of the medicines or treatment in lactation was absent. Despite the popularity of complementary medicines, participants felt more confident in providing advice in relation to conventional over complementary medicines. Whilst medication safety is within the field of expertise of pharmacists, the absence of information and safety data was seen as a major challenge and barrier to enable pharmacists to confidently provide evidence-based recommendations. This study has enhanced our understanding of the attitudes and perspectives of community pharmacists towards the use of non-prescription, including complementary medicines, during breastfeeding. Future studies are warranted to confirm the safety of commonly used or requested

  1. Attitudes of North Carolina law enforcement officers toward syringe decriminalization

    Science.gov (United States)

    Davis, Corey S.; Johnston, Jill; Zerden, Lisa de Saxe; Clark, Katie; Castillo, Tessie; Childs, Robert

    2015-01-01

    Background North Carolina, like much of the U.S. South, is disproportionately affected by HIV and hepatitis. This persistently high disease burden may be driven in part by laws that criminalize the possession and distribution of syringes for illicit drug use. Legal change to decriminalize syringes may reduce infection rates in the state, but is unlikely absent support from law enforcement actors. Methods We analyzed the responses of 350 North Carolina law enforcement officers to a confidential, anonymous survey. The survey instrument collected data regarding self-reported needle-stick injury (NSI), blood borne disease risk perception and attitudes toward syringe decriminalization. Results 82% of respondents reported that contracting HIV was a “big concern” for them. 3.8% of respondents reported ever receiving a job-related NSI, a rate of 36 NSI per 10,000 officer-years. Majorities of respondents reported positive views regarding syringe decriminalization, with approximately 63% agreeing that it would be “good for the community” and 60% agreeing that it would be “good for law enforcement.” Black and female officers were significantly less likely to agree that on-the-job NSI was a “big concern” and significantly more likely to agree that it would be good for law enforcement. Conclusions These findings suggest that many North Carolina LEOs understand the public health benefits of syringe access programs and may be inclined to support syringe decriminalization legislation. Further research is indicated to determine the causes of observed differences in perceptions of bloodborne disease risk and attitudes toward syringe decriminalization by race and sex. PMID:25193720

  2. 76 FR 76096 - Non-Face-to-Face Sale and Distribution of Tobacco Products and Advertising, Promotion, and...

    Science.gov (United States)

    2011-12-06

    ... Advertising, Promotion, and Marketing of Tobacco Products; Extension of Comment Period AGENCY: Food and Drug... related to non-face-to- face sale and distribution of tobacco products; the advertising, promotion, and...- face-to-face sale and distribution of tobacco products and the advertising, promotion, and marketing of...

  3. Non-medical use of prescription drugs in a national sample of college women.

    Science.gov (United States)

    McCauley, Jenna L; Amstadter, Ananda B; Macdonald, Alexandra; Danielson, Carla Kmett; Ruggiero, Kenneth J; Resnick, Heidi S; Kilpatrick, Dean G

    2011-07-01

    Non-medical use of prescription drugs (NMUPD) is one of the fastest growing forms of illicit drug use, with research indicating that college students represent a particularly high risk population. The current study examined demographic characteristics, health/mental health, substance misuse, and rape experiences as potential risk correlates of NMUPD among a national sample of college women (N=2000). Interviews were conducted via telephone using Computer-Assisted Telephone Interviewing technology. NMUPD was assessed by asking if, participants had used a prescription drug non-medically in the past year. NMUPD was endorsed by 7.8% of the sample (n=155). Although incapacitated and drug-alcohol facilitated rape were associated with NMUPD in the initial model, the final multivariable model showed that only lifetime major depression and other forms of substance use/abuse were significantly uniquely associated with an increased likelihood of NMUPD. Implications for primary and secondary prevention and subsequent research are addressed. Published by Elsevier Ltd.

  4. Sharing of Needles and Syringes among Men Who Inject Drugs: HIV Risk in Northwest Bangladesh.

    Directory of Open Access Journals (Sweden)

    M Kamal Pasa

    sharing. Utilization and impact of risk reduction programmes might be improved with expanded clean needle/syringe distribution at times and venues convenient for PWID, better trained and non-judgmental staff, and medical assistance for health problems, including drug withdrawal symptoms.

  5. Non-steroidal anti-inflammatory drugs and antibiotics prescription trends at a central west bank hospital.

    Science.gov (United States)

    Tayem, Yasin I; Qubaja, Marwan M; Shraim, Riyad K; Taha, Omar B; Abu Shkheidem, Imadeddin A; Ibrahim, Murad A

    2013-11-01

    We aimed to reliably describe the pattern of outpatient prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics (ATBs) at a central hospital in the West Bank, Palestine. This was a retrospective, cross-sectional study investigating a cohort of 2,208 prescriptions ordered by outpatient clinics and the emergency room over one year in Beit Jala Hospital in Bethlehem, West Bank. The orders were analysed for the rate and types of NSAIDs and ATBs utilised, and the appropriateness of these drugs to the diagnosis. Of the total prescriptions, 410 contained NSAIDs (18.6%), including diclofenac (40.2%), low dose aspirin (23.9%), ibuprofen (17.8%) and indomethacin (15.1%). A minority of these prescriptions contained a combination of these agents (2.5%). Only one prescription contained cyclooxyeganse-2 inhibitors (0.2%). The appropriateness of NSAID use to the diagnosis was as follows: appropriate (58.3%), inappropriate (14.4%) and difficult to tell (27.3%). The rate of ATB use was 30.3% (669 prescriptions). The ATBs prescribed were amoxicillin (23.3%), augmentin (14.3%), quinolones (12.7%), first and second generation cephalosporins (9.4% and 12.7%, respectively) and macrolides (7.2%). ATB combinations were identified in 9.4%, with the most common being second-generation cephalopsorins and metronidazole (4.3%). Regarding the appropriateness of prescribing ATBs according to the diagnosis, it was appropriate in 44.8%, inappropriate in 20.6% and difficult to tell in 34.6% of the prescriptions. These findings revealed a relatively large number and inappropriate utilisation of ATBs and NSAIDs. An interventional programme needs to be adopted to reinforce physicians' knowledge of the rational prescription of these agents.

  6. A Comparison of Protein Stability in Prefillable Syringes Made of Glass and Plastic.

    Science.gov (United States)

    Waxman, Lloyd; Vilivalam, Vinod D

    2017-01-01

    The development of protein therapeutics requires stabilization of these labile molecules during shipment and storage. Biologics, particularly monoclonal antibodies, are frequently packaged at high concentration in prefillable syringes traditionally made of glass. However, some biologics are unstable in glass due to sensitivity to silicone oil, tungsten, glue, or metal ions. Syringes made from the plastic cyclic olefin polymer, Daikyo Crystal Zenith® (CZ), with a Flurotec-laminated piston, have none of these issues. This study compared the stability of several proteins including biotherapeutics when stored up to 14 months at 5 °C and 25 °C in prefillable siliconized syringes made of glass or silicone oil-free CZ syringes, and when subjected to mild agitation by end-over-end rotation at room temperature. At each time point, proteins were analyzed by several techniques including turbidity, size exclusion high-performance liquid chromatography, reversed phase high-performance liquid chromatography, ion-exchange chromatography, electrophoresis, and light scattering to monitor changes in aggregation and degradation. The results show that proteins have comparable stability when stored in glass syringes or in syringes made of CZ sterilized by E-beam or autoclave. In addition, proteins stressed by agitation were generally more stable and aggregated less in syringes made of CZ than in ones made of glass. LAY ABSTRACT: Biotherapeutic protein drugs such as monoclonal antibodies are frequently packaged at high concentration in prefillable syringes, which allows the drug to be directly administered by the patient or caregiver. Protein drugs, or biologics, can be unstable, and may aggregate, particularly when shaken. These aggregates can be immunogenic, stimulating the body's immune system to produce antibodies that can reduce the drug's efficacy. Although prefillable syringes are traditionally made of glass, some biologics are unstable in glass syringes due to the presence of

  7. Use of non-steroidal anti-inflammatory drugs that elevate cardiovascular risk: an examination of sales and essential medicines lists in low-, middle-, and high-income countries.

    Directory of Open Access Journals (Sweden)

    Patricia McGettigan

    Full Text Available BACKGROUND: Certain non-steroidal anti-inflammatory drugs (NSAIDs (e.g., rofecoxib [Vioxx] increase the risk of heart attack and stroke and should be avoided in patients at high risk of cardiovascular events. Rates of cardiovascular disease are high and rising in many low- and middle-income countries. We studied the extent to which evidence on cardiovascular risk with NSAIDs has translated into guidance and sales in 15 countries. METHODS AND FINDINGS: Data on the relative risk (RR of cardiovascular events with individual NSAIDs were derived from meta-analyses of randomised trials and controlled observational studies. Listing of individual NSAIDs on Essential Medicines Lists (EMLs was obtained from the World Health Organization. NSAID sales or prescription data for 15 low-, middle-, and high-income countries were obtained from Intercontinental Medical Statistics Health (IMS Health or national prescription pricing audit (in the case of England and Canada. Three drugs (rofecoxib, diclofenac, etoricoxib ranked consistently highest in terms of cardiovascular risk compared with nonuse. Naproxen was associated with a low risk. Diclofenac was listed on 74 national EMLs, naproxen on just 27. Rofecoxib use was not documented in any country. Diclofenac and etoricoxib accounted for one-third of total NSAID usage across the 15 countries (median 33.2%, range 14.7-58.7%. This proportion did not vary between low- and high-income countries. Diclofenac was by far the most commonly used NSAID, with a market share close to that of the next three most popular drugs combined. Naproxen had an average market share of less than 10%. CONCLUSIONS: Listing of NSAIDs on national EMLs should take account of cardiovascular risk, with preference given to low risk drugs. Diclofenac has a risk very similar to rofecoxib, which was withdrawn from worldwide markets owing to cardiovascular toxicity. Diclofenac should be removed from EMLs.

  8. Antidepressant sales and the risk for alcohol-related and non-alcohol-related suicide in Finland--an individual-level population study.

    Science.gov (United States)

    Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

    2014-01-01

    A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. We followed a nationally representative sample of 950,158 Finnish adults in 1995-2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976-0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995-2007. However, the rise in the proportion of antidepressant users receiving minimally adequate treatment, possibly

  9. 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.

  10. HIV Risk Behavior among Amphetamine Injectors at U.S. Syringe Exchange Programs

    Science.gov (United States)

    Braine, Naomi; Des Jarlais, Don C.; Goldblatt, Cullen; Zadoretzky, Cathy; Turner, Charles

    2005-01-01

    The goal of this study was to compare HIV risk behaviors of amphetamine and non-amphetamine injectors at syringe exchange programs (SEP) in the United States and to identify factors associated with injection risk. This analysis is based on data from a random cross-section of participants at 13 SEPs in different parts of the country. All interviews…

  11. Establishing a Link Between Prescription Drug Abuse and Illicit Online Pharmacies: Analysis of Twitter Data.

    Science.gov (United States)

    Katsuki, Takeo; Mackey, Tim Ken; Cuomo, Raphael

    2015-12-16

    Youth and adolescent non-medical use of prescription medications (NUPM) has become a national epidemic. However, little is known about the association between promotion of NUPM behavior and access via the popular social media microblogging site, Twitter, which is currently used by a third of all teens. In order to better assess NUPM behavior online, this study conducts surveillance and analysis of Twitter data to characterize the frequency of NUPM-related tweets and also identifies illegal access to drugs of abuse via online pharmacies. Tweets were collected over a 2-week period from April 1-14, 2015, by applying NUPM keyword filters for both generic/chemical and street names associated with drugs of abuse using the Twitter public streaming application programming interface. Tweets were then analyzed for relevance to NUPM and whether they promoted illegal online access to prescription drugs using a protocol of content coding and supervised machine learning. A total of 2,417,662 tweets were collected and analyzed for this study. Tweets filtered for generic drugs names comprised 232,108 tweets, including 22,174 unique associated uniform resource locators (URLs), and 2,185,554 tweets (376,304 unique URLs) filtered for street names. Applying an iterative process of manual content coding and supervised machine learning, 81.72% of the generic and 12.28% of the street NUPM datasets were predicted as having content relevant to NUPM respectively. By examining hyperlinks associated with NUPM relevant content for the generic Twitter dataset, we discovered that 75.72% of the tweets with URLs included a hyperlink to an online marketing affiliate that directly linked to an illicit online pharmacy advertising the sale of Valium without a prescription. This study examined the association between Twitter content, NUPM behavior promotion, and online access to drugs using a broad set of prescription drug keywords. Initial results are concerning, as our study found over 45,000 tweets

  12. Non-prescription proton-pump inhibitors for self-treating frequent heartburn:the role of the Canadian pharmacist

    Science.gov (United States)

    Armstrong, David; Nakhla, Nardine

    2016-01-01

    Heartburn and acid regurgitation are the cardinal symptoms of gastroesophageal reflux and occur commonly in the Canadian population. Multiple non-prescription treatment options are available for managing these symptoms, including antacids, alginates, histamine-H2 receptor antagonists (H2RAs), and proton-pump inhibitors (PPIs). As a result, pharmacists are ideally positioned to recommend appropriate treatment options based upon an individual’s needs and presenting symptoms, prior treatment response, comorbid medical conditions, and other relevant factors. Individuals who experience mild heartburn and/or have symptoms that occur predictably in response to known precipitating factors can manage their symptoms by avoiding known triggers and using on-demand antacids and/or alginates or lower-dose non-prescription H2RAs (e.g. ranitidine 150 mg). For those with moderate symptoms, lifestyle changes, in conjunction with higher-dose non-prescription H2RAs, may be effective. However, for individuals with moderate-to-severe symptoms that occur frequently (i.e. ≥2 days/week), the non-prescription (Schedule II) PPI omeprazole 20 mg should be considered. The pharmacist can provide important support by inquiring about the frequency and severity of symptoms, identifying an appropriate treatment option, and recognizing other potential causes of symptoms, as well as alarm features and atypical symptoms that would necessitate referral to a physician. After recommending an appropriate treatment, the pharmacist can provide instructions for its correct use. Additionally, the pharmacist should inquire about recurrences, respond to questions about adverse events, provide monitoring parameters, and counsel on when referral to a physician is warranted. Pharmacists are an essential resource for individuals experiencing heartburn; they play a crucial role in helping individuals make informed self-care decisions and educating them to ensure that therapy is used in an optimal, safe, and

  13. Social marketing of low dead space syringes in Vietnam: findings from a 1-year pilot program in Hanoi, Thai Nguyen, and Ho Chi Minh City.

    Science.gov (United States)

    Huong, Ngo Thi Thanh; Mundy, Gary; Neukom, Josselyn; Zule, William; Tuan, Nguyen Minh; Tam, Nguyen Minh

    2015-05-30

    Although a growing body of evidence suggests that low dead space syringes may reduce the risk of human immunodeficiency virus (HIV) and Hepatitis C virus infection associated with sharing syringes among people who inject drugs, there is little evidence of effective approaches to motivate people who inject drugs (PWID) to shift from high to low dead space syringes. Using a mix of consumer and trade marketing approaches, informed by rapid assessments of both the syringe market and PWID preferences, practices, and behaviors in Hanoi and Ho Chi Minh City, Population Services International (PSI) Vietnam piloted an intervention to increase the use of low dead space syringes (LDSS) in the three provinces of Hanoi, Ho Chi Minh City, and Thai Nguyen, where an estimated 31% of PWID are HIV positive and 58% are living with hepatitis C virus (HCV). This paper provides a summary of the social marketing activities implemented and results achieved by PSI Vietnam during an initial 1-year pilot period from December 2012 to December 2013 in these three provinces to explore their effectiveness in motivating PWID to use low dead space syringes. We found major increases in sales of LDSS accompanied by increases in reported use and consistent use of LDSS among PWID in the three provinces included in the pilot program and a positive and independent association (odds ratio (OR) 21.08; 95% confidence interval (CI) 10.6-27.3) between LDSS use and exposure to social marketing activities. We also found that LDSS use had a stronger association with perceptions of LDSS product quality than with perceptions regarding LDSS potential to reduce HIV transmission risk and use. We conclude that social marketing interventions have an important role to play in widening access to and the use of LDSS for PWID, as they address the need for PWID to find LDSS when and where they need them and also promote the benefits of LDSS use to PWID. High coverage of these activities among PWID appears to be the key in

  14. 21 CFR 870.1670 - Syringe actuator for an injector.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Syringe actuator for an injector. 870.1670 Section 870.1670 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... actuator for an injector. (a) Identification. A syringe actuator for an injector is an electrical device...

  15. 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.

  16. Impact of alcohol and alcohol mixed with energy drinks on non-medical prescription stimulant use in a nationally representative sample of 12th-grade students.

    Science.gov (United States)

    Housman, Jeff M; Williams, Ronald D; Woolsey, Conrad L

    2016-08-01

    Approximately 30% of high school students use energy drinks. Alcohol use and alcohol mixed with energy drink use (AmED) is associated with risky behavior, including non-medical prescription stimulant use. We assessed alcohol-only, AmED and non-medical prescription stimulant use among 12th grade students in the U.S. using a nationally representative secondary data from the 2012 Monitoring the Future Study. Wilcoxon-Mann-Whitney tests and logistic regression analyses were used to determine differences in non-medical prescription stimulant use by students who used alcohol-only versus AmED and to identify covariates of non-medical prescription stimulant use. Pearson-product moment coefficients were used to determine strength of variable relationships. Significant differences were found in frequency of Ritalin (p energy drink and AmED use, as the combined effects of stimulants contained in energy drinks and the depressant effects of alcohol appear to be associated with increased non-medical prescription stimulant use. Research on the influential factors related to energy drinks, alcohol, and non-medical prescription stimulants will help practitioners to more appropriately design prevention and intervention strategies addressing these high-risk behaviors. (Am J Addict 2016;25:378-384). © 2016 American Academy of Addiction Psychiatry.

  17. Survival of Hepatitis C Virus in Syringes: Implication for Transmission among Injection Drug Users

    Science.gov (United States)

    Paintsil, Elijah; He, Huijie; Peters, Christopher; Lindenbach, Brett D.; Heimer, Robert

    2010-01-01

    Background We hypothesized that the high prevalence of HCV among injection drug users (IDUs) might be due to prolonged virus survival in contaminated syringes. Methods We developed a microculture assay to examine the viability of HCV. Syringes were loaded with blood spiked with HCV reporter virus (Jc1/GLuc2A) to simulate two scenarios of residual volumes; low (2 μl) void volume for 1-ml insulin syringes, and high (32 μl) void volume for 1-ml tuberculin syringes. Syringes were stored at 4°C, 22°C, and 37°C for up to 63 days before testing for HCV infectivity using luciferase activity. Results The virus decay rate was biphasic (t½ α = 0.4h and t½β = 28h). Insulin syringes failed to yield viable HCV beyond day one at all storage temperatures except for 4o in which 5% of syringes yielded viable virus on day 7. Tuberculin syringes yielded viable virus from 96%, 71%, and 52% of syringes following storage at 4o, 22° and 37o for 7 days, respectively, and yielded viable virus up to day 63. Conclusions The high prevalence of HCV among IDUs may be partly due to the resilience of the virus and the syringe type. Our findings may be used to guide prevention strategies. PMID:20726768

  18. Epinephrine syringe exchange events in a paediatric cardiovascular ICU: analysing the storm.

    Science.gov (United States)

    Achuff, Barbara-Jo; Achuff, Jameson C; Park, Hwan H; Moffett, Brady; Acosta, Sebastian; Rusin, Craig G; Checchia, Paul A

    2018-03-01

    Introduction Haemodynamically unstable patients can experience potentially hazardous changes in vital signs related to the exchange of depleted syringes of epinephrine to full syringes. The purpose was to determine the measured effects of epinephrine syringe exchanges on the magnitude, duration, and frequency of haemodynamic disturbances in the hour after an exchange event (study) relative to the hours before (control). Materials and methods Beat-to-beat vital signs recorded every 2 seconds from bedside monitors for patients admitted to the paediatric cardiovascular ICU of Texas Children's Hospital were collected between 1 January, 2013 and 30 June, 2015. Epinephrine syringe exchanges without dose/flow change were obtained from electronic records. Time, magnitude, and duration of changes in systolic blood pressure and heart rate were characterised using Matlab. Significant haemodynamic events were identified and compared with control data. In all, 1042 syringe exchange events were found and 850 (81.6%) had uncorrupted data for analysis. A total of 744 (87.5%) exchanges had at least 1 associated haemodynamic perturbation including 2958 systolic blood pressure and 1747 heart-rate changes. Heart-rate perturbations occurred 37% before exchange and 63% after exchange, and 37% of systolic blood pressure perturbations happened before syringe exchange, whereas 63% occurred after syringe exchange with significant differences found in systolic blood pressure frequency (pexchange events.

  19. The impact of citrate introduction at UK syringe exchange programmes: a retrospective cohort study in Cheshire and Merseyside, UK

    Directory of Open Access Journals (Sweden)

    Wareing Michelle

    2007-12-01

    Full Text Available Abstract Background In 2003, it became legal in the UK for syringe exchange programmes (SEPs to provide citrate to injecting drug users to solubilise heroin. Little work has been undertaken on the effect of policy change on SEP function. Here, we examine whether the introduction of citrate in Cheshire and Merseyside SEPs has altered the number of heroin/crack injectors accessing SEPs, the frequency at which heroin/crack injectors visited SEPs and the number of syringes dispensed. Methods Eleven SEPs in Cheshire and Merseyside commenced citrate provision in 2003. SEP-specific data for the six months before and six months after citrate was introduced were extracted from routine monitoring systems relating to heroin and crack injectors. Analyses compared all individuals attending pre and post citrate and matched analyses only those individuals attending in both periods (defined as 'longitudinal attenders'. Non-parametric tests were used throughout. Results Neither new (first seen in either six months period nor established clients visited SEPs more frequently post citrate. New clients collected significantly less syringes per visit post citrate, than pre citrate (14.5,10.0; z = 1.992, P Conclusion The introduction of citrate did not negatively affect SEP attendance. 'Longitudinal attenders' visited SEPs more frequently post citrate, providing staff with greater opportunity for intervention and referral. As the number of syringes they collected each visit remained unchanged the total number of clean syringes made available to this group of injectors increased very slightly between the pre and post citrate periods. However, new clients collected significantly less syringes post citrate than pre citrate, possibly due to staff concerns regarding the amount of citrate (and thus syringes to dispense safely to new clients. These concerns should not be allowed to negatively impact on the number of syringes dispensed.

  20. Widening consumer access to medicines: a comparison of prescription to non-prescription medicine switch in Australia and New Zealand.

    Directory of Open Access Journals (Sweden)

    Natalie J Gauld

    Full Text Available Despite similarities in health systems and Trans-Tasman Harmonization of medicines scheduling, New Zealand is more active than Australia in 'switching' (reclassifying medicines from prescription to non-prescription.To identify and compare enablers and barriers to switch in New Zealand and Australia.We conducted and analyzed 27 in-depth personal interviews with key participants in NZ and Australia and international participants previously located in Australia, and analyzed records of meetings considering switches (2000-2013. Analysis of both sets of data entailed a heuristic qualitative approach that embraced the lead researcher's knowledge and experience.The key themes identified were conservatism and political influences in Australia, and an open attitude, proactivity and flexibility in NZ. Pharmacist-only medicine schedules and individuals holding a progressive attitude were proposed to facilitate switch in both countries. A pharmacy retail group drove many switches in NZ ('third-party switch', unlike Australia. Barriers to switch in both countries included small market sizes, funding of prescription medicines and cost of doctor visits, and lack of market exclusivity. In Australia, advertising limitations for pharmacist-only medicines reportedly discouraged industry from submitting switch applications. Perceptions of pharmacy performance could help or hinder switches.Committee and regulator openness to switch, and confidence in pharmacy appear to influence consumer access to medicines. The pharmacist-only medicine schedule in Australasia and the rise of third-party switch and flexibility in switch in NZ could be considered elsewhere to enable switch.

  1. Widening consumer access to medicines: a comparison of prescription to non-prescription medicine switch in Australia and New Zealand.

    Science.gov (United States)

    Gauld, Natalie J; Kelly, Fiona S; Emmerton, Lynne M; Buetow, Stephen A

    2015-01-01

    Despite similarities in health systems and Trans-Tasman Harmonization of medicines scheduling, New Zealand is more active than Australia in 'switching' (reclassifying) medicines from prescription to non-prescription. To identify and compare enablers and barriers to switch in New Zealand and Australia. We conducted and analyzed 27 in-depth personal interviews with key participants in NZ and Australia and international participants previously located in Australia, and analyzed records of meetings considering switches (2000-2013). Analysis of both sets of data entailed a heuristic qualitative approach that embraced the lead researcher's knowledge and experience. The key themes identified were conservatism and political influences in Australia, and an open attitude, proactivity and flexibility in NZ. Pharmacist-only medicine schedules and individuals holding a progressive attitude were proposed to facilitate switch in both countries. A pharmacy retail group drove many switches in NZ ('third-party switch'), unlike Australia. Barriers to switch in both countries included small market sizes, funding of prescription medicines and cost of doctor visits, and lack of market exclusivity. In Australia, advertising limitations for pharmacist-only medicines reportedly discouraged industry from submitting switch applications. Perceptions of pharmacy performance could help or hinder switches. Committee and regulator openness to switch, and confidence in pharmacy appear to influence consumer access to medicines. The pharmacist-only medicine schedule in Australasia and the rise of third-party switch and flexibility in switch in NZ could be considered elsewhere to enable switch.

  2. Prevalence of prescription and illicit drugs in pregnancy-associated non-natural deaths of Florida mothers, 1999-2005.

    Science.gov (United States)

    Hardt, Nancy; Wong, Tit D; Burt, Martha J; Harrison, Ross; Winter, Will; Roth, Jeffrey

    2013-11-01

    Abuse of prescription and illicit drugs has been rapidly increasing. This study examines the prevalence of drug use in the non-natural deaths of pregnant or recently pregnant women. Records from Florida's Pregnancy Associated Mortality Review conducted between 1999 and 2005 (n = 415) were linked to 385 toxicology reports obtained from Florida medical examiners' offices. The final study sample consisted of 169 drug-positive, pregnancy-associated non-natural deaths. Of these, 86 were positive for both blood and urine, 64 were positive for blood only and five for urine only, and the remainder were positive for some other specimen. Among these deaths, 91 cases (54%) involved prescription drugs, 78 cases (46%) involved illicit drugs, and 69 cases (41%) involved alcohol. Opioids constituted the majority of deaths associated with prescription drugs. Substantial co-use of opioids and benzodiazepines was seen. Pregnant or recently pregnant women may have more interactions with healthcare providers, which may present more opportunities for intervention and prevention. © 2013 American Academy of Forensic Sciences.

  3. Potential savings from an evidence-based consumer-oriented public education campaign on prescription drugs.

    Science.gov (United States)

    Donohue, Julie M; Fischer, Michael A; Huskamp, Haiden A; Weissman, Joel S

    2008-10-01

    To estimate potential savings associated with the Consumer Reports Best Buy Drugs program, a national educational program that provides consumers with price and effectiveness information on prescription drugs. National data on 2006 prescription sales and retail prices paid for angiotensin-converting enzyme inhibitors (ACEIs), β-blockers, calcium channel blockers, and 3-hydroxy-3-methylglutaryl coenzyme A (HMG-coA) reductase inhibitors (statins). We converted national data on aggregate unit sales of drugs in the four classes to defined daily doses (DDD) and estimated a range of potential savings from generic and therapeutic substitution. We estimated that $2.76 billion, or 7.83 percent of sales, could be saved if use of the drugs recommended by the educational program was increased. The recommended drugs' prices were 15-65 percent lower per DDD than their therapeutic alternatives. The majority (57.4 percent) of potential savings would be achieved through therapeutic substitution. Substantial savings can be achieved through greater use of comparatively effective and lower cost drugs recommended by a national consumer education program. However, barriers to dissemination of consumer-oriented drug information must be addressed before savings can be realized. © Health Research and Educational Trust.

  4. Spring-loaded syringe for multiple rapid injections

    Directory of Open Access Journals (Sweden)

    C R Srinivas

    2017-01-01

    Full Text Available Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage.

  5. Spring-loaded Syringe for Multiple Rapid Injections

    Science.gov (United States)

    Srinivas, CR; Somani, Anirudh; Shashidharan Nair, CK; Mylswamy, Thirumurthy

    2017-01-01

    Mesotherapy refers to multiple injections of small quantity of the drug over a large area. The mesoguns available are expensive and the motor-driven models tends to waste the expensive material to be injected since the plunger stops after injecting without recoil. We searched for a less expensive device which would inject like the mesogun and still not waste the solution. On searching the web, we identified a spring-loaded syringe. We describe the assembly and use of this inexpensive syringe for delivering multiple injections with minimal wastage. PMID:28529423

  6. How many people in Canada use prescription opioids non-medically in general and street drug using populations?

    Science.gov (United States)

    Popova, Svetlana; Patra, Jayadeep; Mohapatra, Satya; Fischer, Benedikt; Rehm, Jürgen

    2009-01-01

    Medical prescriptions for opioids as well as their non-medical use have increased in Canada in recent years. This study aimed to estimate the number of non-medical prescription opioid (PO) users in the general and street drug using populations in Canada. The number of non-medical PO users among the general population and the number of non-medical PO users, heroin users, or both among the street drug using population was estimated for Canada and for the most populous Canadian provinces. Different estimation methods were used: 1) the number of non-medical PO users in the Canadian general population was estimated based on Canadian availability data, and the ratio of US availability to non-medical PO use from US survey data; 2) numbers within the street drug using population were indirectly estimated based on overdose death data, and a key informants survey. Distribution and trends by usage of opioids were determined by using the multi-site Canadian OPICAN cohort data. Between 321,000 to 914,000 non-medical PO users were estimated to exist among the general population in Canada in 2003. The estimated number of non-medical PO users, heroin users, or both among the street drug using population was about 72,000, with more individuals using nonmedical PO than heroin in 2003. Based on data from the OPICAN survey, in 2005 the majority of the street drug using population in main Canadian cities was non-medical PO users, with the exception of Vancouver and Montreal. A relative increase of 24% was observed from 2002 to 2005 in the proportion of the street drug using population who used non-medical POs only. There is an urgent need to further assess the extent and patterns of non-medical prescription opioid use, related problems and drug distribution channels in Canada.

  7. Approaches for quantifying antimicrobial consumption per animal species based on national sales data: a Swiss example, 2006 to 2013.

    Science.gov (United States)

    Carmo, Luís P; Schüpbach-Regula, Gertraud; Müntener, Cedric; Chevance, Anne; Moulin, Gérard; Magouras, Ioannis

    2017-02-09

    Antimicrobial use in animals is known to contribute to the global burden of antimicrobial resistance. Therefore, it is critical to monitor antimicrobial sales for livestock and pets. Despite the availability of veterinary antimicrobial sales data in most European countries, surveillance currently lacks consumption monitoring at the animal species level. In this study, alternative methods were investigated for stratifying antimicrobial sales per species using Swiss data (2006-2013). Three approaches were considered: (i) Equal Distribution (ED) allocated antimicrobial sales evenly across all species each product was licensed for; (ii) Biomass Distribution (BMD) stratified antimicrobial consumption, weighting the representativeness of each species' total biomass; and (iii) Longitudinal Study Extrapolation (LSE) assigned antimicrobial sales per species based on a field study describing prescription patterns in Switzerland. LSE is expected to provide the best estimates because it relies on field data. Given the Swiss example, BMD appears to be a reliable method when prescription data are not available, whereas ED seems to underestimate consumption in species with larger populations and higher treatment intensity. These methods represent a valuable tool for improving the monitoring systems of veterinary antimicrobial consumption across Europe. This article is copyright of The Authors, 2017.

  8. Antidepressant Sales and the Risk for Alcohol-Related and Non-Alcohol-Related Suicide in Finland—An Individual-Level Population Study

    Science.gov (United States)

    Moustgaard, Heta; Joutsenniemi, Kaisla; Myrskylä, Mikko; Martikainen, Pekka

    2014-01-01

    Objectives A marked decline in suicide rates has co-occurred with increased antidepressant sales in several countries but the causal connection between the trends remains debated. Most previous studies have focused on overall suicide rates and neglected differential effects in population subgroups. Our objective was to investigate whether increasing sales of non-tricyclic antidepressants have reduced alcohol- and non-alcohol-related suicide risk in different population subgroups. Methods We followed a nationally representative sample of 950,158 Finnish adults in 1995–2007 for alcohol-related (n = 2,859) and non-alcohol-related (n = 8,632) suicides. We assessed suicide risk by gender and social group according to regional sales of non-tricyclic antidepressants, measured by sold doses per capita, prevalence of antidepressant users, and proportion of antidepressant users with doses reflecting minimally adequate treatment. Fixed-effects Poisson regression models controlled for regional differences and time trends that may influence suicide risk irrespective of antidepressant sales. Results The number of sold antidepressant doses per capita and the prevalence of antidepressant users were unrelated to male suicide risk. However, one percentage point increase in the proportion of antidepressant users receiving minimally adequate treatment reduced non-alcohol-related male suicide risk by one percent (relative risk 0.987, 95% confidence interval 0.976–0.998). This beneficial effect only emerged among men with high education, high income, and employment, among men without a partner, and men not owning their home. Alcohol-related suicides and female suicides were unrelated to all measures of antidepressant sales. Conclusion We found little evidence that increase in overall sales or in the prevalence of non-tricyclic antidepressant users would have caused the fall in suicide rates in Finland in 1995–2007. However, the rise in the proportion of antidepressant

  9. Making Nasopalatine Blocks Comfortable: A Randomised Prospective Clinical Comparison of Pain Associated with the Injection Using an Insulin Syringe and a Standard Disposable 3 mL Syringe.

    Science.gov (United States)

    Prabhu, Sundararaman; Faizel, Syed; Pahlajani, Vedant; Prabhu, Shweta Jha

    2013-12-01

    This study was conducted to compare and evaluate the pain associated with administration of Nasopalatine blocks using a disposable insulin syringe and the conventional disposable 3 mL syringe. Forty patients requiring intraalveolar extractions of maxillary central incisors were randomly assigned to two groups of 20 patients each; one (Group A) received the nasopalatine block with a standard 3mL syringe and the other (Group B) received the block with an insulin syringe. Patients were asked to rate the pain associated with the injection on a visual analog scale (VAS) and the results were analysed using a Chi Square Test. The mean VAS score for Group A and B was 1.55 and 1 respectively. Chi Square value was calculated to be 8.603 (degree of freedom= 3, P value= 0.0351). There were no differences in the effectiveness of anesthesia between the groups. Pain associated with administration of the nasopalatine blocks may be significantly mitigated by using the Insulin syringe.

  10. Syringe access for the prevention of blood borne infections among injection drug users

    Directory of Open Access Journals (Sweden)

    Rich Josiah D

    2003-11-01

    Full Text Available Abstract Background Approximately one-third of acquired immunodeficiency syndrome cases in the United States are associated with the practice of sharing of injection equipment and are preventable through the once-only use of syringes, needles and other injection equipment. Discussion Sterile syringes may be obtained legally by 4 methods depending on the state. They may be purchased over the counter, prescribed, obtained at syringe exchange programs or furnished by authorized agencies. Each of these avenues has advantages and disadvantages; therefore, legal access through all means is the most likely way to promote the use of sterile syringes. Summary By assisting illicit drug injectors to obtain sterile syringes the primary care provider is able to reduce the incidence of blood borne infections, and educate patients about safe syringe disposal. The provider is also able to initiate discussion about drug use in a nonjudgmental manner and to offer care to patients who are not yet ready to consider drug treatment.

  11. Detection of illicit online sales of fentanyls via Twitter.

    Science.gov (United States)

    Mackey, Tim K; Kalyanam, Janani

    2017-01-01

    A counterfeit fentanyl crisis is currently underway in the United States.  Counterfeit versions of commonly abused prescription drugs laced with fentanyl are being manufactured, distributed, and sold globally, leading to an increase in overdose and death in countries like the United States and Canada.  Despite concerns from the U.S. Drug Enforcement Agency regarding covert and overt sale of fentanyls online, no study has examined the role of the Internet and social media on fentanyl illegal marketing and direct-to-consumer access.  In response, this study collected and analyzed five months of Twitter data (from June-November 2015) filtered for the keyword "fentanyl" using Amazon Web Services.  We then analyzed 28,711 fentanyl-related tweets using text filtering and a machine learning approach called a Biterm Topic Model (BTM) to detect underlying latent patterns or "topics" present in the corpus of tweets.  Using this approach we detected a subset of 771 tweets marketing the sale of fentanyls online and then filtered this down to nine unique tweets containing hyperlinks to external websites.  Six hyperlinks were associated with online fentanyl classified ads, 2 with illicit online pharmacies, and 1 could not be classified due to traffic redirection.  Importantly, the one illicit online pharmacy detected was still accessible and offered the sale of fentanyls and other controlled substances direct-to-consumers with no prescription required at the time of publication of this study.   Overall, we detected a relatively small sample of Tweets promoting illegal online sale of fentanyls.  However, the detection of even a few online sellers represents a public health danger and a direct violation of law that demands further study.

  12. Variability in syringe components and its impact on functionality of delivery systems.

    Science.gov (United States)

    Rathore, Nitin; Pranay, Pratik; Eu, Bruce; Ji, Wenchang; Walls, Ed

    2011-01-01

    Prefilled syringes and autoinjectors are becoming increasingly common for parenteral drug administration primarily due to the convenience they offer to the patients. Successful commercialization of such delivery systems requires thorough characterization of individual components. Complete understanding of various sources of variability and their ranking is essential for robust device design. In this work, we studied the impact of variability in various primary container and device components on the delivery forces associated with syringe injection. More specifically, the effects of barrel size, needle size, autoinjector spring force, and frictional forces have been evaluated. An analytical model based on underlying physics is developed that can be used to fully characterize the design space for a product delivery system. Use of prefilled syringes (syringes prefilled with active drug) is becoming increasingly common for injectable drugs. Compared to vials, prefilled syringes offer higher dose accuracy and ease of use due to fewer steps required for dosage. Convenience to end users can be further enhanced through the use of prefilled syringes in combination with delivery devices such as autoinjectors. These devices allow patients to self-administer the drug by following simple steps such as pressing a button. These autoinjectors are often spring-loaded and are designed to keep the needle tip shielded prior to injection. Because the needle is not visible to the user, such autoinjectors are perceived to be less invasive than syringes and help the patient overcome the hesitation associated with self-administration. In order to successfully develop and market such delivery devices, we need to perform an in-depth analysis of the components that come into play during the activation of the device and dose delivery. Typically, an autoinjector is activated by the press of a button that releases a compressed spring; the spring relaxes and provides the driving force to push the

  13. Direct observation of syringeal muscle function in songbirds and a parrot

    DEFF Research Database (Denmark)

    Larsen, Ole Næsbye; Goller, Franz

    2002-01-01

    on the syrinx. Contraction of m. tracheobronchialis ventralis enlarges the syringeal lumen and thus increases airflow by abducting the LL but does not affect the ML. The largest syringeal muscle, m. syringealis ventralis, plays a minor role, if any, in direct aperture control and thus in gating airflow...... the LTMs further into the tracheal lumen but does not close the syringeal aperture fully. The intrinsic deep muscle, m. syringealis profundus, abducts the LTMs through cranio-laterad movement of a paired, protruding half-ring. The weakly developed extrinsic m. sternotrachealis seems to increase tension......The role of syringeal muscles in controlling the aperture of the avian vocal organ, the syrinx, was evaluated directly for the first time by observing and filming through an endoscope while electrically stimulating different muscle groups of anaesthetised birds. In songbirds (brown thrashers...

  14. Syringe calibration factors and volume correction factors for the NPL secondary standard radionuclide calibrator

    CERN Document Server

    Tyler, D K

    2002-01-01

    The activity assay of a radiopharmaceutical administration to a patient is normally achieved via the use of a radionuclide calibrator. Because of the different geometries and elemental compositions between plastic syringes and glass vials, the calibration factors for syringes may well be significantly different from those for the glass containers. The magnitude of these differences depends on the energies of the emitted photons. For some radionuclides variations have been observed of 70 %, it is therefore important to recalibrate for syringes or use syringe calibration factors. Calibration factors and volume correction factors have been derived for the NPL secondary standard radionuclide calibrator, for a variety of commonly used syringes and needles, for the most commonly used medical radionuclide.

  15. Potential of prescription registries to capture individual-level use of aspirin and other nonsteroidal anti-inflammatory drugs in Denmark: trends in utilization 1999–2012

    Directory of Open Access Journals (Sweden)

    Schmidt M

    2014-05-01

    Full Text Available Morten Schmidt,1 Jesper Hallas,2 Søren Friis1,31Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Pharmacology, University of Southern Denmark, Odense, Denmark; 3Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, DenmarkBackground: Due to over-the-counter availability, no consensus exists on whether adequate information on nonsteroidal anti-inflammatory drug (NSAID use can be obtained from prescription registries.Objectives: To examine utilization of aspirin and nonaspirin NSAIDs in Denmark between 1999 and 2012 and to quantify the proportion of total sales that was sold on prescription.Method: Based on nationwide data from the Danish Serum Institute and the Danish National Prescription Registry, we retrieved sales statistics for the Danish primary health care sector to calculate 1-year prevalences of prescription users of aspirin or nonaspirin NSAIDs, and to estimate the corresponding proportions of total sales dispensed on prescription.Results: Both low-dose aspirin and nonaspirin NSAIDs were commonly used in the Danish population between 1999 and 2012, particularly among elderly individuals. The 1-year prevalence of prescribed low-dose aspirin increased throughout the study period, notably among men. Nonaspirin NSAID use was frequent in all age groups above 15 years and showed a female preponderance. Overall, the prevalence of prescribed nonaspirin NSAIDs decreased moderately after 2004, but substantial variation according to NSAID subtype was observed; ibuprofen use increased, use of all newer selective cyclooxygenase-2 inhibitors nearly ceased after 2004, diclofenac use decreased by nearly 50% after 2008, and naproxen use remained stable. As of 2012, the prescribed proportion of individual-level NSAID sales was 92% for low-dose aspirin, 66% for ibuprofen, and 100% for all other NSAIDs.Conclusion: The potential for identifying NSAID use from prescription

  16. Syringe Sharing Among a Prospective Cohort of Street-Involved Youth: Implications for Needle Distribution Programs.

    Science.gov (United States)

    Bozinoff, Nikki; Wood, Evan; Dong, Huiru; Richardson, Lindsey; Kerr, Thomas; DeBeck, Kora

    2017-09-01

    The sharing of previously used syringes is associated with the transmission of Hepatitis C and HIV. This longitudinal study examines syringe borrowing and syringe lending within a prospective cohort of street-involved youth in Vancouver, Canada. From September 2005 to May 2014, data were collected from the At-Risk Youth Study, a cohort of street-involved youth age 14-26 at enrollment, and analyzed using generalized estimating equations. Among 505 participants, 142 (28.1%) reported syringe borrowing and 132 (26.1%) reported syringe lending during the study period. In separate multivariable analyses, having difficulty finding clean needles and homelessness were significantly associated with syringe borrowing (Adjusted Odds Ratio (AOR) = 2.28, 95% CI 1.66-3.12 and AOR = 1.52, CI 1.05-2.21, respectively) and syringe lending (AOR = 1.89, 95% CI 1.32-2.71 and AOR = 1.65, 95% CI 1.11-2.44, respectively) (all p values people is warranted.

  17. Low-Cost Touchscreen Driven Programmable Dual Syringe Pump for Life Science Applications

    OpenAIRE

    Liu, Jamin; Garcia, Valentina; Derisi, Joseph

    2018-01-01

    Syringe pumps are powerful tools able to automate routine laboratory practices that otherwise consume large amounts of manual labor time. Commercially available syringe pumps are expensive, difficult to customize, and often preset for a narrow range of operations. Here, we show how to build a programmable dual syringe pump (PDSP) that overcomes these limitations. The PDSP is driven by a Raspberry Pi paired with a stepper motor controller to allow maximal customization via Python scripting. Th...

  18. The Association between Non-Medical Prescription Drug Use and Suicidal Behavior among United States Adolescents

    Directory of Open Access Journals (Sweden)

    Amanda L. Divin

    2014-11-01

    Full Text Available Adolescence represents a vulnerable time for the development of both drug use/abuse and mental illness. Although previous research has substantiated a relationship between drug use and suicidal behavior, little research has examined this relationship with non-medical prescription drug use. Given the growing prevalence of non-medical prescription drug use (NMPDU among adolescents, this study explored the association between NMPDU and suicidal behavior. Nationally representative data were derived from 16, 410 adolescents who completed the 2009 National Youth Risk Behavior Survey. Approximately 19.8% of participants reported lifetime NMPDU. NMPDU was associated with significantly increased odds of suicidal behavior (P < 0.01, with seriously considering attempting suicide and making a plan about attempting suicide representing the strongest correlates for males and females. Results suggest the importance of 1 continued reinforcement of drug education programs in high school begun at earlier ages and 2 mental health care and screenings among adolescents.

  19. Aquagenic syringeal acrokeratoderma

    Directory of Open Access Journals (Sweden)

    Belkiz Uyar

    2014-01-01

    Full Text Available Aquagenic syringeal acrokeratoderma is a rare, transient, and usually bilaterally symmetric, palmoplantar keratoderma. Patients complain of tingling and pain in the hands starting a few minutes after exposure to water and lasting for 20-30 minutes after removal. Clinically, there is marked wrinkling with edematous white papules on the palms or, less often, the soles. We present the case of a 21-year-old woman who used spironolactone for polycystic ovary syndrome and had similar clinical features 2 weeks later, after withdrawing the drug.

  20. Syringe vending machines for injection drug users: an experiment in Marseille, France.

    Science.gov (United States)

    Obadia, Y; Feroni, I; Perrin, V; Vlahov, D; Moatti, J P

    1999-01-01

    OBJECTIVES: This study evaluated the usefulness of vending machines in providing injection drug users with access to sterile syringes in Marseille, France. METHODS: Self-administered questionnaires were offered to 485 injection drug users obtaining syringes from 32 pharmacies, 4 needle exchange programs, and 3 vending machines. RESULTS: Of the 343 respondents (response rate = 70.7%), 21.3% used the vending machines as their primary source of syringes. Primary users of vending machines were more likely than primary users of other sources to be younger than 30 years, to report no history of drug maintenance treatment, and to report no sharing of needles or injection paraphernalia. CONCLUSIONS: Vending machines may be an appropriate strategy for providing access to syringes for younger injection drug users, who have typically avoided needle exchange programs and pharmacies. PMID:10589315

  1. The benefits and drawbacks of syringe drivers in palliative care.

    Science.gov (United States)

    Costello, John; Nyatanga, Brian; Mula, Carole; Hull, Jenny

    2008-03-01

    This article will outline the use of continuous subcutaneous infusion pumps, known as syringe drivers, including their benefits and drawbacks in a palliative care context. There have been over 5000 articles published globally describing syringe drivers in the medical and nursing literature within the last decade. Many provide guidance on their use, although much of the data are repetitious, disease or age-group specific, and focused on pragmatic issues to do with clinical application. Several trusts and hospices across the UK are carrying out trials of the recently launched McKinley T34 syringe driver. Therefore, it seems timely to consider their wider use internationally. Globally, practitioners in palliative care are very familiar with their use, although the literature lacks specific guidance and, at times, the information is ambiguous. Having briefly reviewed their benefits, the article considers the limitations of using syringe drivers and comments on some of the lesser known/reported practical and patient-focused drawbacks associated with their use. We conclude by considering why, when so much education and training exists to help practitioners use these devices effectively, so many human errors occur.

  2. 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.

  3. Reuse prevention syringes for reconstitution of lyophilized vaccines: Operational study and UNICEF plans for expanding introduction.

    Science.gov (United States)

    Fleming, Jessica A; Hoekstra, Edward John; Moniaga, Vanda; Widjaya, Anton; Soepardi, Jane; Supartha, Nyoman; Salovaara, Annika; Khamassi, Selma; Nelson, Carib

    2009-01-01

    Since the 1990s, the United Nation's Children's Fund has encouraged injection safety for immunizations through bundling vaccines with appropriate amounts of supporting equipment and by supplying autodisable (AD) syringes for injections. However, poor vaccine reconstitution practices continue to be reported worldwide. By 2009, UNICEF will begin to phase out the distribution of standard disposable syringes for vaccine reconstitution and replace them with reuse prevention (RUP) syringes, with a full transition expected by the end of 2010. A field evaluation in Indonesia was conducted to identify introduction requirements, issues with healthcare worker training and acceptance, and RUP syringe performance and safety. Managers and health workers felt that RUP syringes improved injection safety and fit easily into country logistical systems. Healthcare workers felt they were intuitive to use, but recommended special training. The integration of RUP reconstitution syringes by UNICEF could increase injection safety by preventing the reuse of syringes and reducing vaccine contamination.

  4. Utilization of a hospital information system for outpatient prescription screening process at the PKU Muhammadiyah Yogyakarta Hospital

    Science.gov (United States)

    Ismail, R.; Perwitasari, D. A.; Supadmi, W.; Risdiana, I.

    2017-11-01

    Prescription screening includes administrative and clinical precision of the drug, dosage, frequency and route of administration, therapeutic duplication, allergic or sensitive reactions, and actual or potential interactions. The study was aimed to identify the obstacles and compliance level of users, as well as the design of a prescription screening information system and its users’ perceptions. This study used qualitative and quantitative research design with action research studies involving pharmacists, pharmacy technicians, a programmer and clinical practice student pharmacists. The obstacle of pharmacists in doing prescription screening was the long duration in the process of manual prescription review. The compliance of pharmacists in manual prescription review was under 50%. The prescription information system was created by the programmer on the proposal of pharmacists in the form of front view, pharmacy display, sales display, prescription display, prescription display per period and display of recapped prescriptions. Perception of the usefulness was very high with a value of 4.5±0.577 and perception of ease of use was very high with a value of 4.214±0.534 from 28 respondents. The prescription information system was created by a programmer upon the recommendations of pharmacists. Perception of the usefulness and ease of use was very high.

  5. An introduction to the Micrel Micropump MP Daily portable syringe driver.

    Science.gov (United States)

    Groves, Karen E

    2003-11-01

    In this article the author describes the Micrel Micropump MP Daily (MP Daily) portable syringe driver. This follows the author's experience of a 4-month pilot of the device by an inpatient palliative care unit. Portable syringe drivers are commonly used to deliver continuous subcutaneous infusions in palliative care situations. Those in current use are not without problems and serious adverse events have occasionally been reported, mainly resulting from confusion between models. The MP Daily syringe driver addresses some of these issues while remaining small, lightweight and inexpensive, with a long battery life and fitting into the pocket of a shirt of pyjama jacket. Improvements over current models include an on/off button, the absence of facilities to set a zero rate or change the rate once the syringe driver is running, and the absence of a boost button. In addition, there are improved alarms, a message display system and a configuration menu. Although confusion remains a problem, and the ideal has not yet been reached, the MP Daily goes some considerable way towards reducing risks and opportunities for human error.

  6. In-syringe-stirring: A novel approach for magnetic stirring-assisted dispersive liquid–liquid microextraction

    International Nuclear Information System (INIS)

    Horstkotte, Burkhard; Suárez, Ruth; Solich, Petr; Cerdà, Víctor

    2013-01-01

    Graphical abstract: -- Highlights: •We propose a new automatic magnetic stirring assisted dispersive liquid–liquid microextraction. •It allows the extraction of aluminum from seawater and freshwater samples within less than 4 min. •The method was applicable to the natural samples. -- Abstract: For the first time, the use of a magnetic stirrer within the syringe of an automated syringe pump and the resulting possible analytical applications are described. A simple instrumentation following roughly the one from sequential injection analyzer systems is used in combination with an adaptor, which is placed onto the barrel of a glass syringe. Swirling around the longitudinal axis of the syringe and holding two strong neodymium magnets, it causes a rotating magnetic field and serves as driver for a magnetic stirring bar placed inside of the syringe. In a first study it was shown that this approach leads to a sealed but also automatically adaptable reaction vessel, the syringe, in which rapid and homogeneous mixing of sample with the required reagents within short time can be carried out. In a second study in-a-syringe magnetic stirring-assisted dispersive liquid–liquid microextraction (MSA-DLLME) was demonstrated by the application of the analyzer system to fluorimetric determination of aluminum in seawater samples using lumogallion. A linear working range up to 1.1 μmol L −1 and a limit of detection of 6.1 nmol L −1 were found. An average recovery of 106.0% was achieved for coastal seawaters with a reproducibility of 4.4%. The procedure lasted 210 s including syringe cleaning and only 150 μL of hexanol and 4.1 mL of sample were required

  7. The evaluation of a trial of syringe vending machines in Canberra, Australia.

    Science.gov (United States)

    McDonald, David

    2009-07-01

    Syringe vending machines (SVMs) have been trialled in Canberra, Australian Capital Territory, Australia, as an intervention aiming to increase the availability of sterile injecting equipment for use by IDUs. This study evaluated the 12-month trial. A utilisation-focused evaluation model, with both formative and summative components, was employed. Four SVMs were installed, each dispensing packs containing four 1 mL syringes and associated injecting paraphernalia. The trial participants were the clients of the SVMs and other key informants. The core measurements used were the number of syringes dispensed in Canberra by SVMs and other outlets, SVM clients' demographics and experiences of and attitudes towards SVMs, perceived impacts of SVMs on needle sharing, unsafe disposal of used syringes in the vicinity of SVMs, and community and stakeholder attitudes. The trial was implemented successfully, with no adverse consequences identified. The SVMs appear to be serving both the usual clients of the other outlets for sterile injecting equipment (community pharmacies and the Needle Syringe Program outlets) and others who are reluctant to use such outlets or find them inconvenient. The out-of-business-hours provision of syringes through the SVMs was particularly welcomed by both SVM clients and other stakeholders. The continuing operation of the initial four SVMs is widely supported, and additional machines are requested by clients and others. Owing to the success of the trial in terms of feasibility and outcomes for both IDUs and for the broader community, it is desirable that providing sterile injecting equipment through SVMs continues and be expanded as an integral component of harm reduction strategies.

  8. 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...

  9. Leisure-time physical activity and prevalence of non-communicable pathologies and prescription medication in Spain.

    Science.gov (United States)

    Fernandez-Navarro, Pablo; Aragones, María Teresa; Ley, Victoria

    2018-01-01

    Our aims were to describe physical activity (PA) behaviour in Spain and to examine its association with the prevalence of some of the major non-communicable diseases and with the use of prescription medication. Individualized secondary data retrieved from the 2014 European Health Interview Survey (EHIS) for Spain were used to conduct a cross-sectional epidemiological study (n = 18926). PA was assessed by two different measures: a specific designed variable for EHIS and a leisure time PA frequency-based query of the national survey. Diseases analyzed were hypertension, diabetes, hypercholesterolemia, depression and anxiety. The use of prescription medication was also included in the study. Weighted percentages were computed and contingency tables were calculated to describe PA by levels of the traits and sociodemographic characteristics. Chi-square test was used to compare percentages between groups and weighted logistic regression models were used to assess the relationship between PA and the prevalence of the disease. About 73% of the Spanish population performs no PA at all or only occasionally during their leisure time, and only one third meets minimum PA international guidelines (≥ 150min/week). Men are considerably more active than women and less PA is observed as the education level decreases and as age increases. The risk of the diseases evaluated was up to three times higher among inactive individuals. This study provides national population-based estimations highlighting the impact of PA in Spain, not only in the prevalence of some of the major non-communicable diseases but also in reducing prescription medication, and the potential sex and socioeconomic influence.

  10. 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.

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

    Directory of Open Access Journals (Sweden)

    Gebremedhin Beedemariam Gebretekle

    2016-01-01

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

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

    Science.gov (United States)

    Gebretekle, Gebremedhin Beedemariam; Serbessa, Mirgissa Kaba

    2016-01-01

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

  13. Influence of Syringe Volume on Foam Stability in Sclerotherapy for Varicose Vein Treatment.

    Science.gov (United States)

    Bai, Taoping; Jiang, Wentao; Fan, Yubo

    2018-05-01

    Despite the popularity of sclerotherapy for treating varicose veins, it still exhibits various problems, such as pulmonary embolism, deep-vein thrombosis, phlebitis, and visual disorders. To investigate syringe volume influence on foam stability, obtain the foam decay rule, and provide a reference for clinics. Five types of syringes are used to prepare foam at room temperature with various liquid-gas ratios. Foam decay process experiments were performed 5 times and recorded by video. The stability indices used include drainage time, half-life, bubble diameter, bubble surface density, and drainage rate. The 30 and 2-mL syringes, respectively, recorded the highest and lowest drainage speeds. Foam drainage time and half-life, differences varied between 15 and 70 seconds, and 20 and 100 seconds, respectively. Foam bubble diameters were distributed over 0.1 to 2.0 mm with roughly 200 to 700 bubbles per square centimeter. Increased syringe volume causes the bubble diameter to increase. Thus, foam dispersion increases and foam half-life decreases; hence, foam becomes unstable. It is, thus, better to use a small syringe several times to prepare foam in clinics using segmented injections.

  14. 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

  15. Large volume syringe pump extruder for desktop 3D printers

    Directory of Open Access Journals (Sweden)

    Kira Pusch

    2018-04-01

    Full Text Available Syringe pump extruders are required for a wide range of 3D printing applications, including bioprinting, embedded printing, and food printing. However, the mass of the syringe becomes a major challenge for most printing platforms, requiring compromises in speed, resolution and/or volume. To address these issues, we have designed a syringe pump large volume extruder (LVE that is compatible with low-cost, open source 3D printers, and herein demonstrate its performance on a PrintrBot Simple Metal. Key aspects of the LVE include: (1 it is open source and compatible with open source hardware and software, making it inexpensive and widely accessible to the 3D printing community, (2 it utilizes a standard 60 mL syringe as its ink reservoir, effectively increasing print volume of the average bioprinter, (3 it is capable of retraction and high speed movements, and (4 it can print fluids using nozzle diameters as small as 100 μm, enabling the printing of complex shapes/objects when used in conjunction with the freeform reversible embedding of suspended hydrogels (FRESH 3D printing method. Printing performance of the LVE is demonstrated by utilizing alginate as a model biomaterial ink to fabricate parametric CAD models and standard calibration objects. Keywords: Additive manufacturing, 3D bioprinting, Embedded printing, FRESH, Soft materials extrusion

  16. Adrenaline in cardiac arrest: Prefilled syringes are faster.

    Science.gov (United States)

    Helm, Claire; Gillett, Mark

    2015-08-01

    Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. Retraction of the Plunger on a Syringe of Hyaluronic Acid Before Injection: Are We Safe?

    Science.gov (United States)

    Carey, Wayne; Weinkle, Susan

    2015-12-01

    Controversy exists concerning the need for aspiration before injection with hyaluronic acid (HA) fillers. The authors undertook a study of HA products to determine if blood could be aspirated back into a syringe of HA when the needle has been primed or filled with HA. Two studies were set up to determine if or when blood could be withdrawn from a heparinized fresh tube of blood into the HA syringe. Two different techniques were tested; one using a slow-pull retraction of the plunger and up to a 5-second waiting time before release versus a rapid pullback and quick release. Review of these data demonstrates that the usual clinical method, which involves quick withdrawal and instant release of the syringe plunger does not allow for sufficient removal of the filler found intraluminal in the needle and may give rise to false negative results in vitro and likely in vivo with the exception being the Galderma/Medicis products. In summary, withdrawal of the syringe plunger with no visible blood in the syringe does not eliminate the possibility of intravascular placement of the syringe needle.

  18. Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

    International Nuclear Information System (INIS)

    Bartosch, R.; Granegger, S.; Sinzinger, H.

    1998-01-01

    Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of 99m Tc-tetrofosmin and 99m Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.)

  19. Review: Taking care of yourself in later life: a qualitative study into the use of non-prescription medicines by people aged 60+.

    Science.gov (United States)

    Leontowitsch, Miranda; Higgs, Paul; Stevenson, Fiona; Rees Jones, Ian

    2010-03-01

    The last 40 years have witnessed substantial changes to the experience of later life. Health and life expectancy have improved and the emergence of a putative third age has allowed post-working life to move beyond being a residual social category to become an arena in which later life lifestyles can be constructed. Greater emphasis is now placed on expectations of self-agency and choice. Allied to this is the growing role of consumerism as a way of organizing key aspects of social life. Not only do these changes place increased emphasis on individual responsibility for health, but they also engage individuals in various forms of health consumerism.This study draws on these aspects of contemporary society to provide an explanatory framework for understanding older people's engagement with, and consumption of non-prescription medicines. We present a qualitative study in which we interviewed 22 men and women aged 60 plus who were purchasing or interested in purchasing non-prescription medicines, including complementary and alternative medicines. Our findings suggest that the use of non-prescription medicines is both pluralistic and makeshift. Moreover, while this pluralism led to tensions with conventional bio-medicine, conventional bio-medicine still maintained the legitimacy of its knowledge base. Self-care using non-prescription medicines appeared more governed by hope than by evidence or knowledge of the treatments concerned.We conclude that such pluralism of approach reflects the growing consumerism in health and self-care and that older people may in fact be similar to other age groups in terms of their approach to such commodification.

  20. Syringe irrigation: blending endodontics and fluid dynamics

    NARCIS (Netherlands)

    Boutsioukis, C.; van der Sluis, L.W.M.; Basrani, B.

    2015-01-01

    Syringe irrigation remains a widely used irrigant delivery method during root canal treatment. An interdisciplinary approach involving well-established methods from the field of fluid dynamics can provide new insights into the mechanisms involved in cleaning and disinfection of the root canal system

  1. The use of prescription medications obtained from non-medical sources among immigrant Latinos in the rural southeastern U.S.

    Science.gov (United States)

    Song, Eun-Young; Leichliter, Jami S; Bloom, Frederick R; Vissman, Aaron T; O'Brien, Mary Claire; Rhodes, Scott D

    2012-05-01

    We explored the relationships between behavioral, socio-cultural, and psychological characteristics and the use of prescription medications obtained from non-medical sources among predominantly Spanish-speaking Latinos in the rural southeastern U.S. Respondent-driven sampling (RDS) was used to identify, recruit, and enroll immigrant Latinos to participate in an interviewer-administered assessment. A total of 164 respondents were interviewed in 2009. Average age was 34 years old, 64% of respondents were female, and nearly 85% reported being from Mexico. Unweighted and RDS-weighted prevalence estimates of any non-medical source of prescription medications were 22.6% and 15.1%, respectively. In multivariable modeling, respondents who perceived their documentation status as a barrier to health care and those with higher educational attainment were significantly more likely to report use of non-medical sources. Interventions are needed to increase knowledge of eligibility to sources of medical care and treatment and ensure culturally congruent services for immigrant communities in the U.S.

  2. Barriers to Access to Sterile Syringes as Perceived by Pharmacists and Injecting Drug Users: Implications for Harm Reduction in Lebanon.

    Science.gov (United States)

    Ghaddar, Ali; Nassar, Karine; Elsoury, Ghadier

    2017-09-19

    Access to sterile syringes to injecting drug users (IDU) reduces sharing behavior and prevents the transmission of HIV. To describe the barriers to access to sterile syringes for IDUs in Lebanon from the perspectives of pharmacists and IDUs. in this qualitative study conducted in Lebanon, data were collected from 72 syringe purchase tests at pharmacies, 64 interviewees with pharmacists and 2 focus groups with injecting drug users. Two independent researchers analyzed the verbatim transcripts. Results revealed that pharmacists often deny access to sterile syringes to IDUs who are frequently stigmatized and intimidated at pharmacies. While no large gender differences in pharmacists' attitudes and practices were observed, inequalities in syringe access were noticed with men IDUs more often denied purchase. Pharmacists had several barriers to sell syringes to IDUs including fear of disease spread, increased drug use, inappropriately discarded syringes, staff and customer safety, and business concerns. IDUs had several challenges to purchase syringes including stigmatization, intimidation, physical harassment, concern to reveal identity, fear of arrest and syringe price abuse. Identifying the barriers to and facilitators of access to sterile syringes to IDUs is important to guide the development of efficient policies. Findings implicate the importance of empowering IDUs to purchase syringes at pharmacies through reducing the negative attitude towards IDUs and strengthening pharmacists' role in the promotion of health of IDUs. Findings also suggest that the habit of syringe sharing would decrease if the legal and cultural barriers to access are reduced.

  3. 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...

  4. Adsorption of technetium-99m tetrofosmin and technetium-99m furifosmin on plastic syringes

    Energy Technology Data Exchange (ETDEWEB)

    Bartosch, R.; Granegger, S.; Sinzinger, H. [Department of Nuclear Medicine, University of Vienna (Austria)

    1998-09-01

    Some groups have reported that adsorption of radiopharmaceuticals on disposable plastic syringes can reach levels of almost 50%. This high loss of radioactivity stimulated us to carry out similar studies. Our measurements were done in combination with patient studies. Therefore, we used 2-ml syringes, all of the same brand. The radioactivity in the syringe was measured immediately before and after injection. a total of 500-600 MBq technetium-99m labelled tetrofosmin or technetium-99m furifosmin was administered to 48 patients using four different injection techniques (n = 6 for each technique with each tracer): with needles, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer; with butterflies, 1 min blood incubation at 22 C, 10 or 30 min after preparation of the tracer. Neither in syringes nor in needles or butterflies did more than 7% of the initial radioactivity remain. The entire residual activity in syringe plus needle or syringe plus butterfly together never exceeded the 9% limit. Furthermore, in a pilot study we measured the remaining radioactivity in the vial; here, too, we found no more than 14% of total radioactivity. These findings indicate that total retention of radioactivity during elution and application of {sup 99m}Tc-tetrofosmin and {sup 99m}Tc-furifosmin with material used in our setting does not approach relevant amounts. (orig.) With 4 figs., 1 tab., 7 refs.

  5. [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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Wang, Jing; Christo, Paul J

    2009-01-01

    the actual rate of abuse may not have been reduced. These 2 studies both point to the challenges the PMPs face. However, more recent data suggest that proactive use of the PMPs results in the decreased growth of prescription medication sales. Finally, a number of states have also begun to objectively evaluate the efficiencies of the system. Many states have developed PMPs to help regulatory agencies as well as physicians detect prescription drug abuse. Limited data so far suggest that such programs reduce abuse practices. In addition, proactive usage of the data further prevents abuse.

  8. Aspects of syringeal mechanics in avian phonation

    NARCIS (Netherlands)

    Larsen, O.N.; Goller, F.; Leeuwen, van J.L.

    2006-01-01

    The vocal organ of birds, the syrinx, is formed by modified cartilages of the trachea and bronchi. Recently, the use of thin, flexible endoscopes has made direct observation of the syrinx possible in situ. The effects of direct muscle stimulation on the syringeal aperture identified adductor and

  9. Association between unemployment rates and prescription drug utilization in the United States, 2007–2010

    Science.gov (United States)

    2012-01-01

    Background While extensive evidence suggests that the economic recession has had far reaching effects on many economic sectors, little is known regarding its impact on prescription drug utilization. The purpose of this study is to describe the association between state-level unemployment rates and retail sales of seven therapeutic classes (statins, antidepressants, antipsychotics, angiotensin-converting enzyme [ACE] inhibitors, opiates, phosphodiesterase [PDE] inhibitors and oral contraceptives) in the United States. Methods Using a retrospective mixed ecological design, we examined retail prescription sales using IMS Health Xponent™ from September 2007 through July 2010, and we used the Bureau of Labor Statistics to derive population-based rates and mixed-effects modeling with state-level controls to examine the association between unemployment and utilization. Our main outcome measure was state-level utilization per 100,000 people for each class. Results Monthly unemployment levels and rates of use of each class varied substantially across the states. There were no statistically significant associations between use of ACE inhibitors or SSRIs/SNRIs and average unemployment in analyses across states, while for opioids and PDE inhibitors there were small statistically significant direct associations, and for the remaining classes inverse associations. Analyses using each state as its own control collectively exhibited statistically significant positive associations between increases in unemployment and prescription drug utilization for five of seven areas examined. This relationship was greatest for statins (on average, a 4% increase in utilization per 1% increased unemployment) and PDE inhibitors (3% increase in utilization per 1% increased unemployment), and lower for oral contraceptives and atypical antipsychotics. Conclusion We found no evidence of an association between increasing unemployment and decreasing prescription utilization, suggesting that any

  10. Syringe Decriminalization Advocacy in Red States: Lessons from the North Carolina Harm Reduction Coalition.

    Science.gov (United States)

    Cloud, David H; Castillo, Tessie; Brinkley-Rubinstein, Lauren; Dubey, Manisha; Childs, Robert

    2018-05-08

    Syringe access programs (SAPs) are cornerstone harm reduction interventions for combatting the national opioid epidemic. The goal of this paper is to describe effective advocacy strategies for enacting syringe decriminalization legislation to foster the expansion of SAPs in high-need areas amidst political opposition. Decades or research shows that SAPs prevent the transmission of HIV among people who inject drugs (PWID) and are a cost-effective tool for linking PWID to medical care, health education, and social services. In the USA, state laws criminalizing distribution and possession of syringes impede the expansion of SAPs into areas where they are sorely needed. In 2016, North Carolina became the first state to legalize SAPs with a Republican super majority. This paper distills strategies for community organizations seeking to advance syringe decriminalization legislation in politically conservative states with histories of prioritizing punitive sanctions over public health responses to drug use.

  11. Homicide by Sch from a syringe-like dart ejected by a compound crossbow.

    Science.gov (United States)

    Guo, Wei; Luo, Guochang; Wang, Hao; Meng, Xiangzhi

    2015-02-01

    The compound crossbow can be used to eject syringe-like dart loaded with poisonous solution. Succinylcholine (Sch) is a short-acting neuromuscular blocker medically used to achieve complete relaxation of muscle for a good intubation condition. Without the help of an artificial respirator, intramuscular injection of a large dose of Sch can paralyze the respiratory muscle and result in the receiver's death. In this paper, we present the homicide case of a young male killed by Sch from a syringe-like dart ejected by a compound crossbow. The subcutaneous and muscular hemorrhages observed around the entry were more severe than that caused by a medical injection. Additionally, other autopsy results showed the external appearance of a pinhole, general asphyxia signs and pathological findings which were not characteristic. The discovery of a syringe-like dart at the scene is the critical clue and reason for analyzing for Sch, which is commonly used to load syringe-like dart to paralyze and steal dog in the countryside of China. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  12. Dump the pump: manual aspiration thrombectomy (MAT) with a syringe is technically effective, expeditious, and cost-efficient.

    Science.gov (United States)

    Gross, Bradley A; Jadhav, Ashutosh P; Jovin, Tudor G; Jankowitz, Brian Thomas

    2018-04-01

    Syringe aspiration for manual aspiration thrombectomy (MAT) is a cost- and time-efficient alternative to an aspiration pump with likely similar efficacy. It is counterintuitive to expect the pump to perform better than direct vacuum with a syringe, as the pump must deliver vacuum additionally through a canister and meters of tubing. To present in vitro and clinical results of MAT with a syringe. An in vitro analysis was performed comparing vacuum pressures generated by syringe aspiration and with pump aspiration. This was then complemented with prospective clinical data providing details of angiographic and clinical outcomes for syringe MAT. The in vitro analysis demonstrated that equal to slightly greater vacuum pressures were generated by a 60 cc syringe as compared with the pump in both static and partial flow conditions. In our clinical series, 106/113 acute stroke thrombectomies over a 6-month period were performed with syringe MAT on the first pass. Syringe usage instead of pump tubing and a canister led to a total savings of $58 300. The rate of Thrombolysis in Cerebral Infarction 2b/3 recanalization was 93%. Adjunctive stentriever usage was performed in 23% of cases. Median puncture to reperfusion time was 25 min; mean change in National Institute of Health Stroke Scale score at 24 hours was an improvement of 5.1 (median 6). The in-hospital mortality rate was 10%. Seventy percent of patients were discharged to home (modified Rankin Scale (mRS) score 0-2) or a rehabilitation facility (mRS score 2-4). MAT using a syringe is a safe, fast, and more cost-effective approach than using an aspiration pump. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. 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...

  14. A syringe-sharing model for the spread of HIV: application to Omsk, Western Siberia.

    Science.gov (United States)

    Artzrouni, Marc; Leonenko, Vasiliy N; Mara, Thierry A

    2017-03-01

    A system of two differential equations is used to model the transmission dynamics of human immunodeficiency virus between 'persons who inject drugs' (PWIDs) and their syringes. Our vector-borne disease model hinges on a metaphorical urn from which PWIDs draw syringes at random which may or may not be infected and may or may not result in one of the two agents becoming infected. The model's parameters are estimated with data mostly from the city of Omsk in Western Siberia. A linear trend in PWID prevalence in Omsk could only be fitted by considering a time-dependent version of the model captured through a secular decrease in the probability that PWIDs decide to share a syringe. A global sensitivity analysis is performed with 14 parameters considered random variables in order to assess their impact on average numbers infected over a 50-year projection. With obvious intervention implications the drug injection rate and the probability of syringe-cleansing are the only parameters whose coefficients of correlations with numbers of infected PWIDs and infected syringes have an absolute value close to or larger than 0.40. © The authors 2015. Published by Oxford University Press on behalf of the Institute of Mathematics and its Applications. All rights reserved.

  15. Detection of illicit online sales of fentanyls via Twitter [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Tim K. Mackey

    2017-11-01

    Full Text Available A counterfeit fentanyl crisis is currently underway in the United States.  Counterfeit versions of commonly abused prescription drugs laced with fentanyl are being manufactured, distributed, and sold globally, leading to an increase in overdose and death in countries like the United States and Canada.  Despite concerns from the U.S. Drug Enforcement Agency regarding covert and overt sale of fentanyls online, no study has examined the role of the Internet and social media on fentanyl illegal marketing and direct-to-consumer access.  In response, this study collected and analyzed five months of Twitter data (from June-November 2015 filtered for the keyword “fentanyl” using Amazon Web Services.  We then analyzed 28,711 fentanyl-related tweets using text filtering and a machine learning approach called a Biterm Topic Model (BTM to detect underlying latent patterns or “topics” present in the corpus of tweets.  Using this approach we detected a subset of 771 tweets marketing the sale of fentanyls online and then filtered this down to nine unique tweets containing hyperlinks to external websites.  Six hyperlinks were associated with online fentanyl classified ads, 2 with illicit online pharmacies, and 1 could not be classified due to traffic redirection.  Importantly, the one illicit online pharmacy detected was still accessible and offered the sale of fentanyls and other controlled substances direct-to-consumers with no prescription required at the time of publication of this study.   Overall, we detected a relatively small sample of Tweets promoting illegal online sale of fentanyls.  However, the detection of even a few online sellers represents a public health danger and a direct violation of law that demands further study.

  16. 25 CFR 163.16 - Forest product sales without advertisement.

    Science.gov (United States)

    2010-04-01

    ... 25 Indians 1 2010-04-01 2010-04-01 false Forest product sales without advertisement. 163.16... FORESTRY REGULATIONS Forest Management and Operations § 163.16 Forest product sales without advertisement. (a) Sales of forest products may be made without advertisement to Indians or non-Indians with the...

  17. Investigating Liquid Leak from Pre-Filled Syringes upon Needle Shield Removal: Effect of Air Bubble Pressure.

    Science.gov (United States)

    Chan, Edwin; Maa, Yuh-Fun; Overcashier, David; Hsu, Chung C

    2011-01-01

    This study is to investigate the effect of headspace air pressure in pre-filled syringes on liquid leak (dripping) from the syringe needle upon needle shield removal. Drip tests to measure drip quantity were performed on syringes manually filled with 0.5 or 1.0 mL of various aqueous solutions. Parameters assessed included temperature (filling and test), bulk storage conditions (tank pressure and the type of the pressurized gas), solution composition (pure water, 0.9% sodium chloride, and a monoclonal antibody formulation), and testing procedures. A headspace pressure analyzer was used to verify the drip test method. Results suggested that leakage is indeed caused by headspace pressure increase, and the temperature effect (ideal gas expansion) is a major, but not the only, factor. The dissolved gases in the liquid bulk prior to or during filling may contribute to leakage, as these gases could be released into the headspace due to solubility changes (in response to test temperature and pressure conditions) and cause pressure increase. Needle shield removal procedures were found to cause dripping, but liquid composition played little role. Overall, paying attention to the processing history (pressure and temperature) of the liquid bulk is the key to minimize leakage. The headspace pressure could be reduced by decreasing liquid bulk storage pressure, filling at a higher temperature, or employing lower solubility gas (e.g., helium) for bulk transfer and storage. Leakage could also be mitigated by simply holding the syringe needle pointing upward during needle shield removal. Substantial advances in pre-filled syringe technology development, particularly in syringe filling accuracy, have been made. However, there are factors, as subtle as how the needle shield (or tip cap) is removed, that may affect dosing accuracy. We recently found that upon removal of the tip cap from a syringe held vertically with needle pointed downwards, a small amount of solution, up to 3-4% of

  18. A complete non-perturbative renormalization prescription for quasi-PDFs

    Energy Technology Data Exchange (ETDEWEB)

    Alexandrou, Constantia [Cyprus Univ., Nicosia (Cyprus). Dept. of Physics; The Cyprus Institute, Nicosia (Cyprus); Cichy, Krzysztof [Frankfurt Univ. (Germany). Inst. fuer Theoretische Physik; Adam Mickiewicz Univ., Poznan (Poland). Faculty of Physics; Constantinou, Martha [Temple Univ., Philadelphia, PA (United States). Dept. of Physics; Hadjiyiannakou, Kyriakos [The Cyprus Institute, Nicosia (Cyprus); Jansen, Karl; Steffens, Fernanda [Deutsches Elektronen-Synchrotron (DESY), Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC; Panagopoulos, Haralambos [Cyprus Univ., Nicosia (Cyprus). Dept. of Physics; Collaboration: European Twisted Mass Collaboration

    2017-06-15

    In this work we present, for the first time, the non-perturbative renormalization for the unpolarized, helicity and transversity quasi-PDFs, in an RI{sup '} scheme. The proposed prescription addresses simultaneously all aspects of renormalization: logarithmic divergences, finite renormalization as well as the linear divergence which is present in the matrix elements of fermion operators with Wilson lines. Furthermore, for the case of the unpolarized quasi-PDF, we describe how to eliminate the unwanted mixing with the twist-3 scalar operator. We utilize perturbation theory for the one-loop conversion factor that brings the renormalization functions to the MS-scheme at a scale of 2 GeV. We also explain how to improve the estimates on the renormalization functions by eliminating lattice artifacts. The latter can be computed in one-loop perturbation theory and to all orders in the lattice spacing. We apply the methodology for the renormalization to an ensemble of twisted mass fermions with N{sub f}=2+1+1 dynamical quarks, and a pion mass of around 375 MeV.

  19. Evaluation and validation of a bee venom sting challenge performed by a micro-syringe.

    Science.gov (United States)

    Cortellini, Gabriele; Severino, Maurizio; Francescato, Elisabetta; Turillazzi, Stefano; Spadolini, Igino; Rogkakou, Anthi; Passalacqua, Giovanni

    2012-12-01

    The honeybee sting challenge is considered a reliable procedure to evaluate the efficacy of specific immunotherapy, but it is difficult and unpractical to perform in clinical practice, because live insects are required. To assess the feasibility and reliability of a challenge test using a micro-syringe, and compared the procedure with sting challenge. Patients on bee venom immunotherapy and without systemic reactions at field sting were enrolled. They underwent a sting challenge with live bee, and large local reactions were assessed up to 48 hours. Those patients displaying systemic reactions at the sting challenge were excluded from the syringe challenge for ethical reasons. The syringe challenge was done by injecting 0.5 μL fresh unfiltered bee venom at 2 mm depth (the length of the sting left by a bee). The same follow-up as at the first challenge was performed. Bee-specific immunoglobulin E (IgE) and tryptase were measured after each challenge. Nineteen patients underwent the sting challenge with live bees. Four had immediate systemic reactions (urticaria or asthma) and were excluded from the second challenge. The remaining 15 patients with large local reaction underwent the syringe challenge. No significant difference was seen in the maximum area of the large local reactions between the challenge with live bees and the syringe challenge. Also, no change was seen in tryptase and specific antibodies. This preliminary study suggests that the micro-syringe challenge with honeybee venom is feasible and produces results indistinguishable from those of the traditional sting challenge. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. 77 FR 31034 - Notice of Realty Action: Non-Competitive Direct Sale of Reversionary Interest Recreation and...

    Science.gov (United States)

    2012-05-24

    ...-08807; MO 4500030924; TAS: 14X5232] Notice of Realty Action: Non-Competitive Direct Sale of Reversionary... check, U.S. postal money order, or bank draft, and made payable in U.S. dollars to the ``Department of... percent deposit. Payment must be submitted in the form of a certified check, U.S. postal money order, bank...

  1. The measurement of activity in vials and syringes using a radionuclide assay calibrator

    International Nuclear Information System (INIS)

    Hooper, S.A.; Davies, I.H.

    1993-01-01

    To enable accurate measurements of the activity in both vials and syringes, a series of measurements was undertaken to ascertain the changes in response with geometry in nine isotope assay calibrators. From these measurements, two jigs were made for each calibrator to enable (a) optimal measurement of activity in vials and (b) optimal measurement of activity in a variety of syringe sizes. (Author)

  2. The pneumatic syringe: a simple apparatus for self-administration of drugs by rats.

    Science.gov (United States)

    Weeks, J R

    1977-12-01

    Drug solution is delivered by a syringe operated by a pneumatic cylinder. Recommended delivery volumes are from 10 to 200 microliter. A solid-state control unit is described which can operate two syringes (drug injection and flush), has outputs for recording responses and injections, and can be programmed to provide several schedules of reinforcement. All components are readily commercially available.

  3. In-syringe magnetic-stirring-assisted liquid-liquid microextraction for the spectrophotometric determination of Cr(VI) in waters.

    Science.gov (United States)

    Henríquez, Camelia; Horstkotte, Burkhard; Solich, Petr; Cerdà, Víctor

    2013-08-01

    A fully automated method for the determination of chromate is described. It is based on the selective reaction of Cr(VI) with diphenylcarbazide in acidic media to form a colored complex of Cr(III) with the oxidation product diphenylcarbazone. The reaction was performed within the syringe of an automatic burette containing a magnetic stirrer for homogenization of the sample and the required reagents. In-syringe stirring was made possible using a specially designed driving device placed around the syringe barrel to achieve a rotating magnetic field in the syringe, forcing the stirrer to spin. In a second step, the reaction mixture in the syringe was neutralized to allow in-syringe magnetic-stirring-assisted dispersive liquid-liquid microextraction of the complex into 125 μL of n-hexanol. After phase separation by droplet flotation over 30 s, the organic phase was propelled into a coupled spectrophotometric detection cell. The entire multistep procedure including in-system standard preparation was done within 270 s. The method was used for the analysis of natural waters, achieving average analyte recovery of 103%, a limit of detection of 0.26 μg L(-1), and a repeatability of less than 4% relative standard deviation.

  4. 75 FR 28063 - M & N Distributors; Dismissal of Proceeding

    Science.gov (United States)

    2010-05-19

    ... expected sales range of the products and statistical probability that various sales levels were consistent... retail marketing and statistics'' ``to analyze national sales data for over-the-counter non- prescription... shown that ``Respondent sold listed chemical products in amounts sufficient to support an inference of...

  5. Syringe-vacuum microfluidics: A portable technique to create monodisperse emulsions.

    Science.gov (United States)

    Abate, Adam R; Weitz, David A

    2011-03-16

    We present a simple method for creating monodisperse emulsions with microfluidic devices. Unlike conventional approaches that require bulky pumps, control computers, and expertise with device physics to operate devices, our method requires only the microfluidic device and a hand-operated syringe. The fluids needed for the emulsion are loaded into the device inlets, while the syringe is used to create a vacuum at the device outlet; this sucks the fluids through the channels, generating the drops. By controlling the hydrodynamic resistances of the channels using hydrodynamic resistors and valves, we are able to control the properties of the drops. This provides a simple and highly portable method for creating monodisperse emulsions.

  6. 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

  7. Prefilled syringes for intravitreal injection reduce preparation time

    DEFF Research Database (Denmark)

    Subhi, Yousif; Kjer, Birgit; Munch, Inger Christine

    2016-01-01

    INTRODUCTION: The demand for intravitreal therapy has increased dramatically with the introduction of vascular endo-thelial growth factor inhibitors. Improved utilisation of existing resources is crucial to meeting the increased future demand. We investigated time spent preparing intravitreal inj...... had no influence on the design of the study, analysis of the data, preparation of the manuscript or the decision to publish. TRIAL REGISTRATION: not relevant.......INTRODUCTION: The demand for intravitreal therapy has increased dramatically with the introduction of vascular endo-thelial growth factor inhibitors. Improved utilisation of existing resources is crucial to meeting the increased future demand. We investigated time spent preparing intravitreal...... injection treatment using either prefilled syringes or vials in routine clinical practice. METHODS: We video-recorded preparations of intravitreal injections (n = 172) for each preparation type (ranibizumab prefilled syringe (n = 56), ranibizumab vial (n = 56) and aflibercept vial (n = 60)) in a multi...

  8. Embedded nanomicro syringe on chip for molecular therapy

    Directory of Open Access Journals (Sweden)

    Jalil MA

    2011-11-01

    Full Text Available Muhammad Arif Jalil1, Nathaporn Suwanpayak2,3, Kathawut Kulsirirat3, Saisudawan Suttirak3, Jalil Ali4, Preecha P Yupapin31Ibnu Sina Institute of Fundamental Science Studies, Nanotechnology Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 2King Mongkut's Institute of Technology Ladkrabang, Chumphon Campus, Chumphon, Thailand; 3Nanoscale Science and Engineering Research Alliance, Advanced Research Center for Photonics, Faculty of Science, King Mongkut's Institute of Technology Ladkrabang, Bangkok, Thailand; 4Institute of Advanced Photonics Science, Nanotechnology Research Alliance, Universiti Teknologi Malaysia, Johor Bahru, MalaysiaBackground: A novel nanomicro syringe system was proposed for drug storage and delivery using a PANDA ring resonator and atomic buffer. A PANDA ring is a modified optical add/drop filter, named after the well known Chinese bear. In principle, the molecule/drug is trapped by the force generated by different combinations of gradient fields and scattering photons within the PANDA ring. A nanomicro needle system can be formed by optical vortices in the liquid core waveguide which can be embedded on a chip, and can be used for long-term treatment. By using intense optical vortices, the required genes/molecules can be trapped and transported dynamically to the intended destinations via the nanomicro syringe, which is available for drug delivery to target tissues, in particular tumors. The advantage of the proposed system is that by confining the treatment area, the effect can be decreased. The use of different optical vortices for therapeutic efficiency is also discussed.Keywords: nanomicro syringe, nanomicro needle, molecular therapy, therapeutic efficiency, cancer

  9. The sales of antidepressants and suicide rates in Norway and its counties 1980-2004.

    Science.gov (United States)

    Bramness, Jørgen G; Walby, Fredrik A; Tverdal, Aage

    2007-09-01

    Suicide is a major public health problem and depression is among the most important risk factors for suicide. Treatment of depression might prevent suicide. To study this hypothesis further we conducted an ecological study. An ecological study using sales data for antidepressants and numbers of suicides in Norway and Norwegian counties 1980-2004 was performed. Data on alcohol consumption and unemployment rates were registered and taken into account. Data were analyzed using Cochrane-Orcutt time series for the country as a whole. The county specific data were analyzed with a random coefficient model with county as subject and intercept and time (slope) as random variables using an unstructured covariance matrix. Sales of non-tricyclic antidepressants (non-TCAs) and suicide were clearly negatively related, even when controlling for alcohol and unemployment (adjusted r(2): 0.57). There was an effect modification between time and level of sales of non-TCAs. Studying the relationship between the sales of non-TCAs and the suicide rate, we found that it was significant and stronger for the low sales figures, but non-existent for the high sales figures. Ecological studies cannot infer causality. The fall in suicide rates in Norway and its counties was related to the increased sales of non-TCAs. The effect was mostly a result of a sales increase in the lower sales segment, indicating that a change from the more toxic TCAs, or heightened awareness of depression and its treatment, could explain the relationship found between sales of newer antidepressants and a decrease in suicide rate.

  10. Microbial contamination of syringes during preparation: the direct influence of environmental cleanliness and risk manipulations on end-product quality.

    Science.gov (United States)

    Stucki, Cyril; Sautter, Anna-Maria; Favet, Jocelyne; Bonnabry, Pascal

    2009-11-15

    The direct influence of environmental cleanliness and risk manipulations on prepared syringes was evaluated. Media-fill testing was used to estimate potential microbial contamination. Syringes were prepared in three different environments using four different uncontrolled high-risk manipulations. The three environments included an International Organization for Standardization (ISO) class 5 horizontal laminar-airflow hood in an ISO class 6 cleanroom (in accordance with United States Pharmacopeia [USP] chapter 797), an ISO class 7 drug preparation area of an operating room, and an uncontrolled decentralized pharmacy in a ward. For each combination of environment and manipulation, 100 syringes were filled by a single operator. The four high-risk manipulations used included simple filling of syringes with trypticase soy broth, three-second contact by the ungloved fingers of the operator with the hub of the syringe, three-second contact between an object and the hub of the syringe, and exposure of the filled syringes to ambient air for 10 minutes. Of the 1500 syringes prepared in three different environments, none produced within the cleanroom contained microorganisms, 6% were contaminated in the operating room, and 16% were contaminated in the ward (p ISO class 5 cleanroom in accordance with USP chapter 797 requirements was demonstrated to be the best way to avoid bacterial or fungal contamination of injectable drugs directly resulting in patient infections.

  11. Stability in Effects of gamma-Irradiated Chinese Medicinal Prescriptions on Protection of Mice from Radiation

    International Nuclear Information System (INIS)

    Yang Jung-Ah; Kim Sung-Ho

    2000-01-01

    The radioprotective effects of irradiated medicinal plants on biological system were studied to apply the irradiation technology for hygienic purpose that is usually performed by chemical preservatives. We previously reported that the three Chinese medicinal prescriptions, Si-Wu-Tang, Bu-Zhong-Yi-Qi-Tang and San-Ling-Bai-Shu-San, showed radioprotective effects in mice. In these experiments, to investigate the difference in radioprotective effects between irradiated (10 kGy) and non-irradiated medicinal plants, mice were administered with the irradiated or non-irradiated prescriptions and then the mice were exposed to gamma-rays with low and high dosage. Non-exposed mice were also prepared as a control. The effects of prescriptions on the jejunal crypt survival, endogenous spleen colony formation, and apoptosis of jejunal crypt cells in mice were investigated after exposure. All of the prescriptions showed the protective effects of the jejunal crypt (p0.05) and the adminstration of the prescriptions increased the formation of endogenous spleen colony (p0.05) and reduced the frequency of radiation-induced apoptosis (p0.05). No significant difference in effects between irradiated and non-irradiated prescreption on the parameters was found in mice administered with each prescription before exposure to gamma-rays. In non-exposed mice, there were no different findings in the parameters between irradiated and non-irradiated prescription

  12. Decreased Odds of Injection Risk Behavior Associated With Direct Versus Indirect Use of Syringe Exchange: Evidence From Two California Cities.

    Science.gov (United States)

    Behrends, Czarina N; Li, Chin-Shang; Gibson, David R

    2017-07-29

    While there is substantial evidence that syringe exchange programs (SEPs) are effective in preventing HIV among people who inject drugs (PWID), nearly all the evidence comes from PWID who obtain syringes from an SEP directly. Much less is known about the benefits of secondary exchange to PWID who get syringes indirectly from friends or acquaintances who visit an SEP for them. We evaluated the effectiveness of direct versus indirect syringe exchange in reducing HIV-related high-risk injecting behavior among PWID in two separate studies conducted in Sacramento and San Jose, California, cities with quite different syringe exchange models. In both studies associations between direct and indirect syringe exchange and self-reported risk behavior were examined with multivariable logistic regression models. Study 1 assessed effects of a "satellite" home-delivery syringe exchange in Sacramento, while Study 2 evaluated a conventional fixed-site exchange in San Jose. Multivariable analyses revealed 95% and 69% reductions, respectively, in high-risk injection associated with direct use of the SEPs in Sacramento and San Jose, and a 46% reduction associated with indirect use of the SEP in Sacramento. Conclusions/Importance: The very large effect of direct SEP use in Sacramento was likely due in part to home delivery of sterile syringes. While more modest effects were associated with indirect use, such use nevertheless is valuable in reducing the risk of HIV transmission of PWID who are unable or unwilling to visit a syringe exchange.

  13. Making a difference? Applying Vitellone's Social Science of the Syringe to performance and image enhancing drug injecting.

    Science.gov (United States)

    Hart, Aaron

    2018-04-18

    Vitellone's Social Science of the Syringe investigates epistemologies of injecting drug use. She argues for a methodology that can be simultaneously sensitive to biopolitical power regimes; the trajectories of social stratification; and the resistance, creativity and dignity of human agency. She proposes a methodological focus on the syringe-in-use as an active participant in these dynamics. Harm reduction policy and service provision frameworks have paid little attention to the phenomena of performance and image enhancing drug (PIEDs) injection. One way of assessing the merit of Vitellone's proposal is to use it to investigate these phenomena. I argue that Vitellone's method can be used to articulate a range of significant differences between people who inject PIEDs and other people who inject drugs, and that these differences can inform harm reduction initiatives. When compared to the heroin syringe, the PIED syringe participates in different socio-economic and material contexts, gendered identities, and biopolitical governance regimes. These differences materialise in different rates of syringe sharing and blood-borne virus transmission; and different experiences of needle exchange services. I offer a thought experiment demonstrating how a different syringe might alter the structural dynamics, biopolitical governance, and the agentic choices of people who inject PIEDs. Judging by the productive effects of diffracting Vitellone's analysis through an empirical concern with PIED injecting, I concur with Vitellone's proposition that 'something objective may be gained from an empirical investigation of the syringe-in-use' (p. 33). Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Change in non-alcoholic beverage sales following a 10-pence levy on sugar-sweetened beverages within a national chain of restaurants in the UK: interrupted time series analysis of a natural experiment.

    Science.gov (United States)

    Cornelsen, Laura; Mytton, Oliver T; Adams, Jean; Gasparrini, Antonio; Iskander, Dalia; Knai, Cecile; Petticrew, Mark; Scott, Courtney; Smith, Richard; Thompson, Claire; White, Martin; Cummins, Steven

    2017-11-01

    This study evaluates changes in sales of non-alcoholic beverages in Jamie's Italian, a national chain of commercial restaurants in the UK, following the introduction of a £0.10 per-beverage levy on sugar-sweetened beverages (SSBs) and supporting activity including beverage menu redesign, new products and establishment of a children's health fund from levy proceeds. We used an interrupted time series design to quantify changes in sales of non-alcoholic beverages 12 weeks and 6 months after implementation of the levy, using itemised electronic point of sale data. Main outcomes were number of SSBs and other non-alcoholic beverages sold per customer. Linear regression and multilevel random effects models, adjusting for seasonality and clustering, were used to investigate changes in SSB sales across all restaurants (n=37) and by tertiles of baseline restaurant SSB sales per customer. Compared with the prelevy period, the number of SSBs sold per customer declined by 11.0% (-17.3% to -4.3%) at 12 weeks and 9.3% (-15.2% to -3.2%) at 6 months. For non-levied beverages, sales per customer of children's fruit juice declined by 34.7% (-55.3% to -4.3%) at 12 weeks and 9.9% (-16.8% to -2.4%) at 6 months. At 6 months, sales per customer of fruit juice increased by 21.8% (14.0% to 30.2%) but sales of diet cola (-7.3%; -11.7% to -2.8%) and bottled waters (-6.5%; -11.0% to -1.7%) declined. Changes in sales were only observed in restaurants in the medium and high tertiles of baseline SSB sales per customer. Introduction of a £0.10 levy on SSBs alongside complementary activities is associated with declines in SSB sales per customer in the short and medium term, particularly in restaurants with higher baseline sales of SSBs. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  15. A study of gross morphological and histological syringeal features of ...

    African Journals Online (AJOL)

    A study of gross morphological and histological syringeal features of true francolins (Galliformes: Francolinus, Scleroptila, Peliperdix and Dendroperdix spp.) and spurfowls ( Pternistis spp.) in a phylogenetic context.

  16. Stability of erythropoietin repackaging in polypropylene syringes for clinical use

    Directory of Open Access Journals (Sweden)

    Angela Marsili

    2017-02-01

    Full Text Available Introduction: Epoetin alfa (Eprex® is a subcutaneous, injectable formulation of short half-life recombinant human erythropoietin (rHuEPO. To current knowledge there are no published studies regarding the stability of rHuEPO once repackaging occurs (r-EPO for clinical trial purposes. Materials and methods: We assessed EPO concentration in Eprex® and r-EPO syringes at 0, 60, 90, and 120 days after repackaging in polypropylene syringes. R-EPO was administered to 56 patients taking part in a clinical trial in Friedreich Ataxia. Serum EPO levels were measured at baseline and 48 h after r-EPO administration. Results: No differences were found between r-EPO and Eprex® syringes, but both globally decreased in total EPO content during storage at 4 °C. Patients receiving r-EPO had similar levels in EPO content as expected from previous trials in Friedreich Ataxia and from pharmacokinetics studies in healthy volunteers. Discussion: We demonstrate that repackaging of EPO does not alter its concentration if compared to the original product (Eprex®. This is true both for repackaging procedures and for the stability in polypropylene tubes. The expiration date of r-EPO can be extended from 1 to 4 months after repackaging, in accordance with pharmacopeia rules.

  17. Investigation of Two Prototypes of Novel Noncontact Technologies for Automated Real-Time Capture of Incremental Drug Administration Data From Syringes.

    Science.gov (United States)

    Eagle, Benjamin; Williams, David J; Dingley, John

    2017-08-01

    An ideal electronic anesthesia recording system would be capable of not only recording physiological data but also injectable drug doses given, including those given incrementally from one syringe, without recourse to manual data entry. We compared 2 prototype devices which wirelessly recognized individual syringes and measured changes in their plunger positions via 2 different optical noncontact means, allowing calculation of incremental drug doses given. Both devices incorporated a radio-frequency identification reader, which wirelessly read a unique code from a radio-frequency identification tag within syringe drug labels. A custom-designed cradle oriented any inserted 1-mL to 20-mL syringe in a repeatable position. The "laser" device had a moving laser beam broken by the end of the syringe plunger. The infrared (IR) device measured time of travel of IR light from a sender to a syringe plunger and back to a receiver. Both devices could therefore determine the drug and volume administered since the previous occasion when any syringe had been used. For each syringe size of 1, 2, 5, 10, and 20 mL, 121 plunger-length measurements were made over their full range, with each machine against a reference method of water filling and weighing using a randomized de Bruijn sequence. For every syringe size, the laser device showed greater accuracy and precision, lower bias, and narrower limits of agreement (95% confidence intervals = bias ± 1.96 SD) than the IR device when compared to the reference method. For all syringe sizes, the range of bias was -0.05 to 0.32 mL for the laser and -2.42 to 1.38 mL for the IR. Lin concordance correlation coefficient values for the IR versus reference methods ranged from 0.6259 to 0.9255, with the lowest coefficients seen in syringes with the shortest distance of plunger travel (2 and 5 mL), while in laser versus reference comparisons, these coefficients were similar (0.9641-0.9981) over all syringe lengths. Both devices measured syringe

  18. 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.

  19. 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

  20. Drug-related deaths and the sales of needles through pharmacies.

    Science.gov (United States)

    Davidson, Peter J; Martinez, Alexis; Lutnick, Alexandra; Kral, Alex H; Bluthenthal, Ricky N

    2015-02-01

    Providing needles to people who inject drugs is a well-proven public health response to the transmission of HIV and other blood borne viruses. Despite over a quarter of a century of research, new concerns about potential unintended negative consequences of needle distribution continue to emerge. Specifically, a claim was recently made that the introduction of pharmacy sales of needles was followed by an increase in overdoses in pharmacy parking lots. If true, this would have serious implications for the design of needle access programs, particularly those involving pharmacy sales of needles. We examine spatial relationships between drug-related deaths and pharmacies in Los Angeles County (population 9.8 million) before and after the 2007 enactment of a California law allowing pharmacy sales of needles without a prescription. Seven thousand and forty-nine drugs related deaths occurred in Los Angeles county from 2000 to 2009 inclusive. Four thousand two hundred and seventy-five of these deaths could be geocoded, and were found to be clustered at the census tract level. We used three methods to examine spatial relationships between overdose death locations and pharmacy locations for two years on either side of the enactment of the pharmacy sales law, and found no statistically significant changes. Among the 711 geocodable deaths occurring in the two years following the change in law, no death was found to occur within 50m of a pharmacy which sold needles. These results are consistent with prior studies which suggest pharmacy sales of needles improve access to needles without causing increased harms to the surrounding community. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. SALES, STORAGE AND SALVAGE

    CERN Multimedia

    Division SPL, groupe logistique; A. Notar

    2000-01-01

    From 3 January 2000 there will be a security barrier in front of the storage-recycling area in bldg 133, which will be accessible only to authorised staff and contractors.You are reminded that the equipment delivered to this area must be unpolluted and non-radioactive. The cost of recycling the equipment will be debited to the budget code of the Division concerned, with the prior approval of the Group Leader.Reminder relating to equipment salesThe Sales Section is open on Thursdays from 13.30 to 15.00 hours only.SPL DivisionLogistics GroupA. Notari

  2. Moderating Effects of Sales Promotion Types

    Directory of Open Access Journals (Sweden)

    Fernando de Oliveira Santini

    2015-04-01

    Full Text Available This paper aims to analyze the influence sales promotion types have on the relationship between perception of financial risk and perception of utilitarian and hedonic value on consumer purchase intentions. To this end, an experiment was conducted involving 589 participants divided into two groups defined by distinct scenarios in which the sales promotion type (monetary vs. non-monetary was manipulated. The working hypotheses predicted a direct and positive relationship between the perception of (hedonic and utilitarian consumption value and purchase intention for a promoted product and a negative relationship between the perception of consumption value and the perception of financial risk. In addition, it was supposed that the sales promotion type would moderate these direct relationships and that a monetary promotion would have a stronger effect on the relationship between purchase intention and perceived product utility, whereas a non-monetary promotion would have a stronger effect on the other relationships (hedonic value and financial risk perceptions. Analysis of the outcomes supported the proposed hypotheses.

  3. Potential air contamination during CO2 angiography using a hand-held syringe: theoretical considerations and gas chromatography.

    Science.gov (United States)

    Cho, David R; Cho, Kyung J; Hawkins, Irvin F

    2006-01-01

    To assess air contamination in the hand-held syringes currently used for CO2 delivery and to determine whether there is an association between their position and the rate of air contamination. Assessment of air contamination in the syringe (20 ml) included theoretical modeling, mathematical calculation, and gas chromatography (GC). The model was used with Fick's first law to calculate the diffusion of CO2 and the amount of air contamination. For GC studies, the syringes were placed in the upright, horizontal, and inverted positions and gas samples were obtained after 5, 10, 20, 30, and 60 min. All trials with each position for each sampling time were performed five times. The amounts of air contamination with time calculated mathematically were 5-10% less than those of GC. With the diffusivity of air-CO2 at 0.1599 cm2/sec (9.594 cm2/min), air contamination was calculated to be 60% at 60 min. With GC air contamination was 13% at 5 min, 31% at 20 min, 43% at 30 min, and 68% at 60 min. There was no difference in air contamination between the different syringe positions. Air contamination occurs in hand-held syringes filled with CO2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions.

  4. Oil sales up, gasoline sales down

    International Nuclear Information System (INIS)

    Tusa, J.

    1999-01-01

    Sales of petroleum products rose by 4.3 % in 1998 compared to 1997, and totalled 9.15 million tonnes. Sales of traffic fuels increased by 1.1 %, and those of heating and fuel oil by 3.7 %. The last time sales of petroleum products were at an equivalent level was back in 1990

  5. Surveillance of gastrointestinal disease in France using drug sales data.

    Science.gov (United States)

    Pivette, Mathilde; Mueller, Judith E; Crépey, Pascal; Bar-Hen, Avner

    2014-09-01

    Drug sales data have increasingly been used for disease surveillance during recent years. Our objective was to assess the value of drug sales data as an operational early detection tool for gastroenteritis epidemics at national and regional level in France. For the period 2008-2013, we compared temporal trends of drug sales for the treatment of gastroenteritis with trends of cases reported by a Sentinel Network of general practitioners. We benchmarked detection models to select the one with the best sensitivity, false alert proportion and timeliness, and developed a prospective framework to assess the operational performance of the system. Drug sales data allowed the detection of seasonal gastrointestinal epidemics occurring in winter with a distinction between prescribed and non-prescribed drugs. Sales of non-prescribed drugs allowed epidemic detection on average 2.25 weeks earlier than Sentinel data. These results confirm the value of drug sales data for real-time monitoring of gastroenteritis epidemic activity. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Autologous fat grafting: use of closed syringe microcannula system for enhanced autologous structural grafting

    Directory of Open Access Journals (Sweden)

    Alexander RW

    2013-04-01

    Full Text Available Robert W Alexander,1 David Harrell2 1Department of Surgery, School of Medicine and Dentistry, University of Washington, Seattle, WA, USA; 2Harvest-Terumo Inc, Plymouth, MA, USA Objectives: Provide background for use of acquiring autologous adipose tissue as a tissue graft and source of adult progenitor cells for use in cosmetic plastic surgery. Discuss the background and mechanisms of action of closed syringe vacuum lipoaspiration, with emphasis on accessing adipose-derived mesenchymal/stromal cells and the stromal vascular fraction (SVF for use in aesthetic, structural reconstruction and regenerative applications. Explain a proven protocol for acquiring high-quality autologous fat grafts (AFG with use of disposable, microcannula systems. Design: Explain the components and advantage of use of the patented super luer-lock and microcannulas system for use with the closed-syringe system. A sequential explanation of equipment selection for minimally traumatic lipoaspiration in small volumes is presented, including use of blunt injection cannulas to reduce risk of embolism. Results: Thousands of AFG have proven safe and efficacious for lipoaspiration techniques for large and small structural fat grafting procedures. The importance and advantages of gentle harvesting of the adipose tissue complex has become very clear in the past 5 years. The closed-syringe system offers a minimally invasive, gentle system with which to mobilize subdermal fat tissues in a suspension form. Resulting total nuclear counting of undifferentiated cells of the adipose-derived -SVF suggests that the yield achieved is better than use of always-on, constant mechanical pump applied vacuum systems. Conclusion: Use of a closed-syringe lipoaspiration system featuring disposable microcannulas offers a safe and effective means of harvesting small volumes of nonmanipulated adipose tissues and its accompanying progenitor cells within the SVF. Closed syringes and microcannulas are

  7. Reductions in non-medical prescription opioid use among adults in Ontario, Canada: are recent policy interventions working?

    Science.gov (United States)

    Fischer, Benedikt; Ialomiteanu, Anca; Kurdyak, Paul; Mann, Robert E; Rehm, Jürgen

    2013-02-14

    Non-medical prescription opioid use (NMPOU) and prescription opioid (PO) related harms have become major substance use and public health problems in North America, the region with the world's highest PO use levels. In Ontario, Canada's most populous province, NMPOU rates, PO-related treatment admissions and accidental mortality have risen sharply in recent years. A series of recent policy interventions from governmental and non-governmental entities to stem PO-related problems have been implemented since 2010. We compared the prevalence of NMPOU in the Ontario general adult population (18 years+) in 2010 and 2011 based on data from the 'Centre for Addiction and Mental Health (CAMH) Monitor' (CM), a long-standing annual telephone interview-based representative population survey of substance use and health indicators. While 'any PO use' (in past year) changed non-significantly from 26.6% to 23.9% (Chi2 = 2.511; df = 1; p =  0.113), NMPOU decreased significantly from 7.7% to 4.0% (Chi2 = 14.786; df = 1; p policy interventions, alongside extensive media reporting, focusing on NMPOU and PO-related harms, and may mean that these interventions have shown initial effects. However, other casual factors could have been involved. Thus, it is necessary to systematically examine whether the observed changes will be sustained, and whether other key PO-related harm indicators (e.g., treatment admissions, accidental mortality) change correspondingly in order to more systematically assess the impact of the policy measures.

  8. Nonmedical prescription drug use among US young adults by educational attainment.

    Science.gov (United States)

    Martins, Silvia S; Kim, June H; Chen, Lian-Yu; Levin, Deysia; Keyes, Katherine M; Cerdá, Magdalena; Storr, Carla L

    2015-05-01

    Little is known about nonmedical use of prescription drugs among non-college-attending young adults in the United States. Data were drawn from 36,781 young adults (ages 18-22 years) from the 2008-2010 National Survey on Drug Use and Health public use files. The adjusted main effects for current educational attainment, along with its interaction with gender and race/ethnicity, were considered. Compared to those attending college, non-college-attending young adults with at least and less than a HS degree had a higher prevalence of past-year nonmedical use of prescription opioids [NMUPO 13.1 and 13.2 %, respectively, vs. 11.3 %, adjusted odds ratios (aORs) 1.21 (1.11-1.33) and 1.25 (1.12-1.40)], yet lower prevalence of prescription stimulant use. Among users, regardless of drug type, non-college-attending youth were more likely to have past-year disorder secondary to use [e.g., NMUPO 17.4 and 19.1 %, respectively, vs. 11.7 %, aORs 1.55 (1.22-1.98) and 1.75 (1.35-2.28)]. Educational attainment interacted with gender and race: (1) among nonmedical users of prescription opioids, females who completed high school but were not enrolled in college had a significantly greater risk of opioid disorder (compared to female college students) than the same comparison for men; and (2) the risk for nonmedical use of prescription opioids was negligible across educational attainment groups for Hispanics, which was significantly different than the increased risk shown for non-Hispanic whites. There is a need for young adult prevention and intervention programs to target nonmedical prescription drug use beyond college campuses.

  9. Sales of diesel fuel up, gasoline sales down

    International Nuclear Information System (INIS)

    Nupponen, J.

    2000-01-01

    The combined sales of petroleum products in Finland during 1999 totalled more than nine million tonnes, which was little changed from the figure for 1998. Sales of traffic fuels increased, while those of fuel oil fell. Diesel fuel sales reached a record level, while sales of gasoline continued their downward trend

  10. Evaluation of clot formation in blood-contrast agent mixture: experimental study on ionic/nonionic contrast agents and plastic/ glass syringes

    International Nuclear Information System (INIS)

    Shim, Hyung Jin; Lee, Jong Beum; Lee, Yong Chul; Lee, Kwan Seh; Kim, Kun Sang

    1991-01-01

    Recent introduction of low-osmolar nonionic contrast agents has allowed the performance of angiography with certain advantages such as reduced pain, reduced osmotic load and other potential advantages, over high osmolar ionic contrast agents. But the potential thrombogenic risk of nonionic contrast agent has been debate because of their weak anticoagulation effect. Several reports have recently documented the formation of thrombi in catheters and syringes containing nonionic contrast agent, and thromboembolic episodes have been noted during angiographic procedures. We have also been experienced blood clotting within blood mixed contrast agent syringe during angiography. Thus, we have studied with blood mixed ionic (Diatrizoate, Ioglicate) agents and nonionic (Iopamidol, Iopromide) agents, that used usually in our hospital, and saline in plastic and glass syringes. Each syringes were checked the clot formation on 10,30,60,90 minutes. Total 340 samples were obtained from 8 adults before angiography. Our data showed that nonionic contrast agents had significantly lesser anticoagulation effect than ionic contrast agents (ρ < 0.0001) on Chi-square test), both in plastic and glass syringes. And formation of clotting in glass syringes were significantly greater than that in plastic syringes (ρ < 0.0001). Thus meticulous technique is required to prevent thrombosis during angiographic procedure using nonionic contrast agents

  11. Potential Air Contamination During CO2 Angiography Using a Hand-Held Syringe: Theoretical Considerations and Gas Chromatography

    International Nuclear Information System (INIS)

    Cho, David R.; Cho, Kyung J.; Hawkins, Irvin F.

    2006-01-01

    Purpose. To assess air contamination in the hand-held syringes currently used for CO 2 delivery and to determine whether there is an association between their position and the rate of air contamination. Methods. Assessment of air contamination in the syringe (20 ml) included theoretical modeling, mathematical calculation, and gas chromatography (GC). The model was used with Fick's first law to calculate the diffusion of CO 2 and the amount of air contamination. For GC studies, the syringes were placed in the upright, horizontal, and inverted positions and gas samples were obtained after 5, 10, 20, 30, and 60 min. All trials with each position for each sampling time were performed five times. Results. The amounts of air contamination with time calculated mathematically were 5-10% less than those of GC. With the diffusivity of air-CO 2 at 0.1599 cm 2 /sec (9.594 cm 2 /min), air contamination was calculated to be 60% at 60 min. With GC air contamination was 13% at 5 min, 31% at 20 min, 43% at 30 min, and 68% at 60 min. There was no difference in air contamination between the different syringe positions. Conclusion. Air contamination occurs in hand-held syringes filled with CO 2 when they are open to the ambient air. The amounts of air contamination over time are similar among syringes placed in the upright, horizontal, and inverted positions

  12. 21 CFR 1314.100 - Sales limits for mail-order sales.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Sales limits for mail-order sales. 1314.100 Section 1314.100 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF JUSTICE RETAIL SALE OF SCHEDULED LISTED CHEMICAL PRODUCTS Mail-Order Sales § 1314.100 Sales limits for mail-order sales. (a) Each...

  13. Factors influencing psychotropic prescription by non-psychiatrist physicians in a nursing home for the elderly in Brazil

    Directory of Open Access Journals (Sweden)

    Florindo Stella

    Full Text Available CONTEXT AND OBJECTIVE: Although psychotropics are one of the classes of medications most prescribed in nursing homes for the elderly, studies examining prescribing patterns are limited in both number and scope. The present study was undertaken to investigate factors associated with general psychotropic use in a nursing home in Brazil. DESIGN AND SETTING: Retrospective observational study at the Nursing Home for the Elderly, Institute of Biosciences, Universidade Estadual Paulista. METHODS: Information on prescriptions was retrieved from the medical records of 108 elderly residents in a nursing home. Sixty-five of these patients, with mean age 74.5 years (± standard deviation 9.4 years, who were taking medications on a regular basis, comprised the sample. The effects of demographic and clinical variables on the psychotropic prescription pattern were examined. RESULTS: Females were more likely to receive psychotropics (p = 0.038. Individuals on medicines for cardiovascular diseases received psychotropics less frequently (p = 0.001. The number of prescribed psychotropics correlated negatively with both age (p = 0.009 and number of non-psychotropic drugs (p = 0.009. CONCLUSIONS: Although preliminary, the present results indicated that cardiovascular disease was the clinical variable that most influenced psychotropic prescription. Physicians' overconcern regarding drug interactions might at least partially explain this result. Further investigations involving larger sample sizes from different regions are warranted to confirm these findings.

  14. Commercial sales: the Common European Sales Law compared to the Vienna Sales Convention

    NARCIS (Netherlands)

    Loos, M.B.M.; Schelhaas, H.

    2013-01-01

    If the Common European Sales Law (CESL) is adopted, commercial parties will have the opportunity to choose between two international legal instruments for the regulation of their international commercial sales contracts. Whereas CESL is available to both consumer and commercial sales contracts, the

  15. Analysing policy interventions to prohibit over-the-counter antibiotic sales in four Latin American countries.

    Science.gov (United States)

    Wirtz, V J; Herrera-Patino, J J; Santa-Ana-Tellez, Y; Dreser, A; Elseviers, M; Vander Stichele, R H

    2013-06-01

    To describe and evaluate policies implemented in Chile, Colombia, Venezuela and Mexico (1995-2009) to prohibit antibiotic OTC sales and explore limitations in available data. We searched and analysed legislation, grey literature and peer-reviewed publications on regulatory interventions and implementation strategies to enforce prohibition of OTC antibiotic sales. We also assessed the impact using private sector retail sales data of antibiotics studying changes in level and consumption trends before and after the policy change using segmented time series analysis. Finally, we assessed the completeness and data quality through an established checklist to test the suitability of the data for analysis of the interventions. Whereas Chile implemented a comprehensive package of interventions to accompany regulation changes, Colombia's reform was limited to the capital district and Venezuela's limited to only some antibiotics and without awareness campaigns. In Mexico, no enforcement was enacted. The data showed a differential effect of the intervention among the countries studied with a significant change in level of consumption in Chile (-5.56 DID) and in Colombia (-1.00DID). In Venezuela and Mexico, no significant change in level and slope was found. Changes in population coverage were identified as principal limitations of using sales data for evaluating the reform impact. Retail sales data can be useful when assessing policy impact but should be supplemented by other data sources such as public sector sales and prescription data. Implementing regulatory enforcement has shown some impact, but a sustainable, concerted approach will be needed to address OTC sales in the future. © 2013 John Wiley & Sons Ltd.

  16. Sales Education Efficacy: Examining the Relationship between Sales Education and Sales Success

    Science.gov (United States)

    Bolander, William; Bonney, Leff; Satornino, Cinthia

    2014-01-01

    Sales education is on the rise and for good reason. Statistics say that sales jobs will continue to grow at a rapid rate over the next few years. Many universities are preparing their students to start their careers in the professional selling function through the inclusion of sales education in their business curriculum. Yet little research…

  17. Willingness to use a supervised injection facility among young adults who use prescription opioids non-medically: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Benjamin A. Bouvier

    2017-02-01

    Full Text Available Abstract Background Supervised injection facilities (SIFs are legally sanctioned environments for people to inject drugs under medical supervision. SIFs currently operate in ten countries, but to date, no SIF has been opened in the USA. In light of increasing overdose mortality in the USA, this study evaluated willingness to use a SIF among youth who report non-medical prescription opioid (NMPO use. Methods Between January 2015 and February 2016, youth with recent NMPO use were recruited to participate in the Rhode Island Young Adult Prescription Drug Study (RAPiDS. We explored factors associated with willingness to use a SIF among participants who had injected drugs or were at risk of initiating injection drug use (defined as having a sex partner who injects drugs or having a close friend who injects. Results Among 54 eligible participants, the median age was 26 (IQR = 24–28, 70.4% were male, and 74.1% were white. Among all participants, when asked if they would use a SIF, 63.0% answered “Yes”, 31.5% answered “No”, and 5.6% were unsure. Among the 31 participants reporting injection drug use in the last six months, 27 (87.1% reported willingness to use a SIF; 15 of the 19 (78.9% who injected less than daily reported willingness, while all 12 (100.0% of the participants who injected daily reported willingness. Compared to participants who were unwilling or were unsure, participants willing to use a SIF were also more likely to have been homeless in the last six months, have accidentally overdosed, have used heroin, have used fentanyl non-medically, and typically use prescription opioids alone. Conclusions Among young adults who use prescription opioids non-medically and inject drugs or are at risk of initiating injection drug use, more than six in ten reported willingness to use a SIF. Established risk factors for overdose, including homelessness, history of overdose, daily injection drug use, heroin use, and fentanyl misuse, were

  18. Container Closure Integrity Testing of Prefilled Syringes.

    Science.gov (United States)

    Peláez, Sarah S; Mahler, Hanns-Christian; Matter, Anja; Koulov, Atanas; Singh, Satish K; Germershaus, Oliver; Mathaes, Roman

    2018-04-04

    Prefilled syringes (PFSs) are increasingly preferred over vials as container closure systems (CCSs) for injectable drug products when facilitated or self-administration is required. However, PFSs are more complex compared to CCSs consisting of vial, rubber stopper and crimp cap. Container closure integrity (CCI) assurance and verification has been a specific challenge for PFSs as they feature several sealing areas. A comprehensive understanding of the CCS is necessary for an appropriate CCI assessment as well as for packaging development and qualification. A comprehensive CCI assessment of six different PFSs from three different manufacturers (including one polymeric PFS) was conducted using helium leak testing. PFS components were manipulated to systematically assess the contribution of the different sealing areas to CCI, namely rigid needle shield (RNS)/needle, RNS/tip cone and the individual ribs of a syringe plunger. The polymeric PFS required an equilibrium measurement for accurate CCIT. The different sealing areas and a single plunger rib were shown to provide adequate CCI. Acceptable tip cap movement until the point of CCI failure was estimated. The assessment of acceptable tip cap movement demonstrated the importance of considering the RNS/tip cone seal design to ensure CCI of the PFS upon post assembly possesses and shipment. Copyright © 2018. Published by Elsevier Inc.

  19. Drugs given by a syringe driver: a prospective multicentre survey of palliative care services in the UK.

    Science.gov (United States)

    Wilcock, Andrew; Jacob, Jayin K; Charlesworth, Sarah; Harris, Elayne; Gibbs, Margaret; Allsop, Helen

    2006-10-01

    The use of a syringe driver to administer drugs by continuous subcutaneous infusion is common practice in the UK. Over time, drug combinations used in a syringe driver are likely to change and the aim of this survey was to obtain a more recent snapshot of practice. On four separate days, at two-week intervals, a questionnaire was completed for every syringe driver in use by 15 palliative care services. Of 336 syringe drivers, the majority contained either two or three drugs, but one-fifth contained only one drug. The median (range) volume of the infusions was 15 (9.5-48) mL, and duration of infusion was generally 24 hours. Only one combination was reported as visually incompatible, and there were 13 site reactions (4% of total). Laboratory physical and chemical compatibility data are available for less than half of the most frequently used combinations.

  20. [Non-antiretroviral drugs uses among HIV-infected persons receiving antiretroviral therapy in Senegal: Costs and factors associated with prescription].

    Science.gov (United States)

    Diouf, A; Youbong, T J; Maynart, M; Ndoye, M; Diéye, F L; Ndiaye, N A; Koita-Fall, M B; Ndiaye, B; Seydi, M

    2017-08-01

    In addition to antiretroviral therapy, non-antiretroviral drugs are necessary for the appropriate care of people living with HIV. The costs of such drugs are totally or partially supported by the people living with HIV. We aimed to evaluate the overall costs, the costs supported by the people living with HIV and factors associated with the prescription of non-antiretroviral drugs in people living with HIV on antiretroviral therapy in Senegal. We conducted a retrospective cohort study on 331 people living with HIV who initiated antiretroviral therapy between 2009 and 2011 and followed until March 2012. The costs of non-antiretroviral drugs were those of the national pharmacy for essential drugs; otherwise they were the lowest costs in the private pharmacies. Associated factors were identified through a logistic regression model. The study population was 61 % female. At baseline, 39 % of patients were classified at WHO clinical stage 3 and 40 % at WHO clinical stage 4. Median age, body mass index and CD4 cells count were 41 years, 18kg/m 2  and 93 cells/μL, respectively. After a mean duration of 11.4 months of antiretroviral therapy, 85 % of patients received at least one prescription for a non-antiretroviral drug. Over the entire study period, the most frequently prescribed non-antiretroviral drugs were cotrimoxazole (78.9 % of patients), iron (33.2 %), vitamins (21.1 %) and antibiotics (19.6 %). The mean cost per patient was 34 Euros and the mean cost supported per patient was 14 Euros. The most expensive drugs per treated patient were antihypertensives (168 Euros), anti-ulcer agents (12 Euros), vitamins (8.5 Euros) and antihistamines (7 Euros). The prescription for a non-antiretroviral drug was associated with advanced clinical stage (WHO clinical stage 3/4 versus stage 1/2): OR=2.25; 95 % CI=1.11-4.57 and viral type (HIV-2 versus HIV-1/HIV-1+HIV-2): OR=0.36; 95 % CI=0.14-0.89. Non-antiretroviral drugs are frequently prescribed to

  1. 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

  2. The Role of Traumatic Event History in Non-Medical Use of Prescription Drugs among a Nationally Representative Sample of US Adolescents

    Science.gov (United States)

    McCauley, Jenna L.; Danielson, Carla Kmett; Amstadter, Ananda B.; Ruggiero, Kenneth J.; Resnick, Heidi S.; Hanson, Rochelle F.; Smith, Daniel W.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    Background: Building on previous research with adolescents that examined demographic variables and other forms of substance abuse in relation to non-medical use of prescription drugs (NMUPD), the current study examined potentially traumatic events, depression, posttraumatic stress disorder (PTSD), other substance use, and delinquent behavior as…

  3. Particle creation and non-equilibrium thermodynamical prescription of dark fluids for universe bounded by an event horizon

    OpenAIRE

    Saha, Subhajit; Biswas, Atreyee; Chakraborty, Subenoy

    2015-01-01

    In the present work, flat FRW model of the universe is considered to be an isolated open thermodynamical system where non-equilibrium prescription has been studied using the mechanism of particle creation. In the perspective of recent observational evidences, the matter distribution in the universe is assumed to be dominated by dark matter and dark energy. The dark matter is chosen as dust while for dark energy, the following choices are considered: (i) Perfect fluid with constant equation of...

  4. A prescription for n-dimensional Vierbeins

    International Nuclear Information System (INIS)

    Bokhari, A.H.; Qadir, A.

    1982-06-01

    Recent developments in supergravity have brought the n-dimensional Vierbein formalism into prominence. Here we provide a prescription for writing down a Vierbein given an arbitrary (in general non-diagonal) metric tensor in a Riemannian or pseudo-Riemannian space. (author)

  5. Effectiveness of state and federal government agreements with major credit card and shipping companies to block illegal Internet cigarette sales.

    Directory of Open Access Journals (Sweden)

    Kurt M Ribisl

    2011-02-01

    Full Text Available Most Internet vendors offer tax-free cigarettes making them cheaper than those sold at stores. This undermines the impact that higher prices have upon reducing consumption. Most Internet tobacco sales have violated taxation and youth access laws, which led to landmark voluntary agreements in 2005 with the major credit card companies and major private shippers to ban payment transactions and shipments for all Internet cigarette sales.To assess whether these bans increased the rate of Internet Cigarette Vendors (ICVs ceasing online sales, decreased the proportion of vendors offering banned payment and shipping options, and decreased consumer traffic to the most popular ICVs.Websites in a longitudinal study of ICVs were visited in 2003 (n = 338, 2004 (n = 775, 2005 (n = 664, 2006 (n = 762, and 2007 (n = 497 to assess whether they were in business and monitor their advertised sales practices. The number of unique monthly visitors to the 50 most popular ICVs at baseline was examined for the period one year before and two years after the bans to determine whether the bans altered traffic.Following the bans, the rate of ICVs ceasing online sales year to year increased, but due to an influx of new vendors, there was a net increase in ICVs. The proportion of vendors accepting banned payment options dropped from 99.2% to 37.4% after the bans, and the proportion offering banned shipping options dropped from 32.2% to 5.6%, but there was a corresponding increase in vendors offering non-banned payment options (e.g., personal checks and shipping options (e.g., US Postal Service. Following the bans, there was a 3.5 fold decline in traffic to the most popular ICV websites.This promising approach to controlling the sale of restricted goods online has implications for regulating other products such as alcohol, firearms, quack cures, and medicines sold without a prescription.

  6. Effectiveness of state and federal government agreements with major credit card and shipping companies to block illegal Internet cigarette sales.

    Science.gov (United States)

    Ribisl, Kurt M; Williams, Rebecca S; Gizlice, Ziya; Herring, Amy H

    2011-02-14

    Most Internet vendors offer tax-free cigarettes making them cheaper than those sold at stores. This undermines the impact that higher prices have upon reducing consumption. Most Internet tobacco sales have violated taxation and youth access laws, which led to landmark voluntary agreements in 2005 with the major credit card companies and major private shippers to ban payment transactions and shipments for all Internet cigarette sales. To assess whether these bans increased the rate of Internet Cigarette Vendors (ICVs) ceasing online sales, decreased the proportion of vendors offering banned payment and shipping options, and decreased consumer traffic to the most popular ICVs. Websites in a longitudinal study of ICVs were visited in 2003 (n = 338), 2004 (n = 775), 2005 (n = 664), 2006 (n = 762), and 2007 (n = 497) to assess whether they were in business and monitor their advertised sales practices. The number of unique monthly visitors to the 50 most popular ICVs at baseline was examined for the period one year before and two years after the bans to determine whether the bans altered traffic. Following the bans, the rate of ICVs ceasing online sales year to year increased, but due to an influx of new vendors, there was a net increase in ICVs. The proportion of vendors accepting banned payment options dropped from 99.2% to 37.4% after the bans, and the proportion offering banned shipping options dropped from 32.2% to 5.6%, but there was a corresponding increase in vendors offering non-banned payment options (e.g., personal checks) and shipping options (e.g., US Postal Service). Following the bans, there was a 3.5 fold decline in traffic to the most popular ICV websites. This promising approach to controlling the sale of restricted goods online has implications for regulating other products such as alcohol, firearms, quack cures, and medicines sold without a prescription.

  7. Availability of prescription drugs for bipolar disorder at online pharmacies.

    Science.gov (United States)

    Monteith, Scott; Glenn, Tasha; Bauer, Rita; Conell, Jörn; Bauer, Michael

    2016-03-15

    There is increasing use of online pharmacies to purchase prescription drugs. While some online pharmacies are legitimate and safe, there are many unsafe and illegal so-called "rogue" online pharmacies. This study investigated the availability of psychotropic drugs online to consumers in the US, using 5 commonly prescribed drugs for bipolar disorder. Using the search term "buy [drug name]" in the Google, Yahoo and Bing search engines, the characteristics of the online pharmacies found on the first two pages of search results were investigated. The availability of the requested dosage and formulations of two brand (Seroquel XR, Abilify) and three generic drugs (lamotrigine, lithium carbonate and bupropion SR) were determined. Of 30 online pharmacies found, 17 (57%) were rated as rogue by LegitScript. Of the 30 pharmacies, 15 (50%) require a prescription, 21 (70%) claim to be from Canada, with 20 of these having a Canadian International Pharmacy association (CIPA) seal on the website. Only 13 of the 20 sites with a CIPA seal were active CIPA members. There were about the same number of trust verification seals on the rogue and legitimate pharmacy sites. Some rogue pharmacies are professional in appearance, and may be difficult for consumers to recognize as rogue. All five brand and generic drugs were offered for sale online, with or without a prescription. However, many substitutions were presented such as different strengths and formulations including products not approved by the FDA. No evaluation of product quality, packaging or purchasing. Psychotropic medications are available online with or without a prescription. The majority of online pharmacy websites were rogue. Physicians should ask about the use of online pharmacies. For those who choose to use online pharmacies, two measures to detect rogue pharmacies are recommended: (1) only purchase drugs from pharmacies that require a prescription, and (2) check all pharmacy verification seals directly on the website

  8. Substance use - prescription drugs

    Science.gov (United States)

    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 ...

  9. Direct-to-consumer sales of genetic services on the Internet.

    Science.gov (United States)

    Gollust, Sarah E; Wilfond, Benjamin S; Hull, Sara Chandros

    2003-01-01

    PURPOSE The increasing use of the Internet to obtain genetics information and to order medical services without a prescription, combined with a rise in direct-to-consumer marketing for genetic testing, suggests the potential for the Internet to be used to sell genetic services. METHODS A systematic World Wide Web search was conducted in May 2002 to assess the availability of genetic services sold directly to consumers on the Internet. RESULTS Out of 105 sites that offered genetic services directly, most offered non-health-related services, including parentage confirmation testing (83%), identity testing (56%), and DNA banking (24%); however, health-related genetic tests were offered through 14 sites (13%). The health-related genetic tests available ranged from standard tests, such as hemochromatosis and cystic fibrosis, to more unconventional tests related to nutrition, behavior, and aging. Of these 14 sites, 5 described risks associated with the genetic services and 6 described the availability of counseling. CONCLUSIONS The availability of direct sales of health-related genetic tests creates the potential for inadequate pretest decision making, misunderstanding test results, and access to tests of questionable clinical value.

  10. 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.

  11. Problems of sales force turnover and possible solutions

    Directory of Open Access Journals (Sweden)

    Tihana Poljak

    2012-12-01

    Full Text Available Fluctuation poses an extremely important problem in the field of sales management and, therefore, it is necessary to research continually its impact on the company as a whole. The aim of this paper is to determine the frequency of fluctuation among the sales staff and sales managers through empirical research while also determining the key factors contributing to a decision to leave the company. Results of research conducted on a sample of sales managers show their belief in the honesty of reasons reported by the sales staff for leaving the company, the importance of financial factors as well as numerous material and non-material instruments of motivation employed in order to keep the fluctuation under control because it creates expenses for the company and increases their own workload, among other reasons. Most sales staff reported a wish for career advancement as their primary motivation for changing jobs, claiming that they are prepared to inform their superiors of that decision without hiding the real reasons etc. From this research it is possible to observe both perspectives – that of sales managers as well as that of the sales staff they manage. Their perspectives contain certain differences, which are understandable considering their respective position within the organization but also reflect human bias.

  12. 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.

  13. Marketing/Sales Students' Understanding of What Counts as Sales

    Science.gov (United States)

    Hoshower, Leon; Gupta, Ashok K.

    2009-01-01

    Improper sales revenue recognition is the single largest issue contributing to financial restatements. Understanding and applying the rules of sales revenue recognition is not just an accounting problem; it is a marketing problem, too. Thus, it is important that the sales force has a basic understanding of the rules of sales recognition and be…

  14. 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

  15. Prescription audit in a paediatric sickle cell clinic in South-West ...

    African Journals Online (AJOL)

    where approximately 75% of the global 300,000 births of affected children ... occlusive crisis is the most common symptom of SCD and ... High rate of antibiotic prescription, low use of opioid analgesics and non- prescription of prophylactic penicillin/ pneumococcal ... records of ten patients to identify potential problems. Two.

  16. Effects of preferred-exercise prescription compared to usual exercise prescription on outcomes for people with non-specific low back pain: a randomized controlled trial [ACTRN12608000524392

    Directory of Open Access Journals (Sweden)

    Keating Jennifer L

    2009-01-01

    Full Text Available Abstract Background Non-specific chronic low back pain (NSCLBP has become a significant problem due to high healthcare utilization, rising costs of care and perceived limitations of effectiveness of many current treatments. Systematic reviews have repeatedly concluded that, on average across participants, exercise for NSCLBP appears effective in decreasing pain and improving function. Not all people with NSCLBP benefit from exercise programs and it would assist care-providers and care-seekers if factors that impact on program effectiveness and success were identified. Methods and design The study will be a randomised controlled trial comparing an exercise rehabilitation program informed by a participant preferences questionnaire compared to a program without this guideline for patients with chronic low back pain. A sample of 150 patients will be recruited in Melbourne, Australia through community-based healthcare clinics that provide supervised exercise rehabilitation programs for people with non-specific chronic low back pain. Clinicians will be randomly assigned to exercise preferences questionnaire or no questionnaire and participants will be allocated in a concealed manner. A qualitative focus group study of exercise instructor feedback about the exercise preferences instrument will be embedded in the research design. Two qualitative focus group studies will also be conducted for participants in the intervention and the control groups to obtain feedback about participants' experiences of the two types of exercise programs. The primary outcomes will be functional ability, pain, fear avoidance, exercise adherence. Discussion This trial will evaluate the effectiveness of individualised exercise prescription compared to usual exercise prescription for NSCLP and, using feedback following the trial, refine the exercise preferences questionnaire.

  17. Using human error theory to explore the supply of non-prescription medicines from community pharmacies.

    Science.gov (United States)

    Watson, M C; Bond, C M; Johnston, M; Mearns, K

    2006-08-01

    The importance of theory in underpinning interventions to promote effective professional practice is gaining recognition. The Medical Research Council framework for complex interventions has assisted in promoting awareness and adoption of theory into study design. Human error theory has previously been used by high risk industries but its relevance to healthcare settings and patient safety requires further investigation. This study used this theory as a framework to explore non-prescription medicine supply from community pharmacies. The relevance to other healthcare settings and behaviours is discussed. A 25% random sample was made of 364 observed consultations for non-prescription medicines. Each of the 91 consultations was assessed by two groups: a consensus group (stage 1) to identify common problems with the consultation process, and an expert group (stages 2 and 3) to apply human error theory to these consultations. Paired assessors (most of whom were pharmacists) categorised the perceived problems occurring in each consultation (stage 1). During stage 2 paired assessors from an expert group (comprising patient safety experts, community pharmacists and psychologists) considered whether each consultation was compliant with professional guidelines for the supply of pharmacy medicines. Each non-compliant consultation identified during stage 2 was then categorised as a slip/lapse, mistake, or violation using human error theory (stage 3). During stage 1 most consultations (n = 75, 83%) were deemed deficient in information exchange. At stage 2, paired assessors varied in attributing non-compliance to specific error types. Where agreement was achieved, the error type most often selected was "violation" (n = 27, 51.9%, stage 3). Consultations involving product requests were less likely to be guideline compliant than symptom presentations (OR 0.30, 95% CI 0.10 to 0.95, p = 0.05). The large proportion of consultations classified as violations suggests that either

  18. 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.

  19. Non-prescription dispensing of emergency oral contraceptives: Recommendations from the German Federal Chamber of Pharmacists [Bundesapothekerkammer

    Directory of Open Access Journals (Sweden)

    Schulz M

    2016-09-01

    Full Text Available Background: Emergency hormonal contraceptives (EHC are contraceptives used to prevent unintended pregnancy following unprotected sexual intercourse (USI or contraceptive failure. The EHCs available without a prescription include medicines containing levonorgestrel (LNG in more than 80 countries and, recently, based on an EU-switch ellaOne®, which contains ulipristal acetate (UPA. EHCs work by stopping or delaying ovulation. Those containing LNG can be used up to 72 hours after USI or contraceptive failure, while UPA can be used up to 120 hours. In the context of the UPA implementation process, Germany switched LNG to non-prescription status as well. Objectives: To develop recommendations, a protocol, and a continuing education program for pharmacists to assure quality when giving advice and dispensing EHCs in community pharmacies without a medical prescription. Methods: The recommendations were developed by an iterative process of drafting, recognizing, and discussing comments and proposals for amendments as well a seeking agreement with a number of stakeholders such as the Federal Ministry of Health (BMG, Federal Institute for Drugs and Medical Devices (BfArM, Federal Chamber of Physicians (BÄK, Drug Commission of German Physicians (AkdÄ, professional organizations/associations of gynaecologists, pharmaceutical OTC-industry as well as government-controlled, private, and church-based organizations and centres providing advice on sex education and family planning. Results: The recommendations were eventually endorsed by the BMG in consultation with the BfArM. Conclusions: The recommendations were made public, published in the professional journal and used in an uncounted number of continuing education programs based on the curriculum and provided by the State Chambers of Pharmacists.

  20. 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

  1. Prescription Drug Abuse

    Science.gov (United States)

    ... 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 ...

  2. Effect of Direct-to-Consumer Advertising on Statin Use in the United States.

    Science.gov (United States)

    Chang, Hsien-Yen; Murimi, Irene; Daubresse, Matthew; Qato, Dima M; Emery, Sherry L; Alexander, G Caleb

    2017-08-01

    The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. We conducted an ecological study for 75 designated market areas from 2005 to 2009 in the United States using linked data regarding televised DTCA volume, non-DTCA marketing and promotion, retail, mail order and long-term care prescription drug sales, prescription drug and ambulatory care health care utilization, and contextual factors such as health care density and socioeconomic status. Main outcomes and measures were volume of sales, number of dispensed prescriptions, and high cholesterol-related outpatient visits. Analyses were conducted in 2016. The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across designated market areas. After adjustment for socioeconomic, demographic, and clinical characteristics, each 100-unit increase in advertisement viewership was associated with a 2.22% [95% confidence interval (CI), 0.30%-4.19%] increase in statin sales. Similar patterns were observed between DTCA and statin dispensing among the commercially insured. DTCA was associated with increases in high cholesterol-related outpatient visits among adults 18-45 years of age (3.15% increase in visits per 100-unit increase in viewership, 95% CI, 0.98%-5.37%) but not among those 46-65 years of age (0.51%, 95% CI, -1.49% to 2.55%). DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.

  3. Impact of health legislation on the sale of anorectics in a city in the Amazon region

    OpenAIRE

    Castro,Luana Valéria da Silva; Farias Junior,Gilvo; Teixeira,Francisco Martins; Vieira,José Ricardo dos Santos; Maia,Cristiane do Socorro Ferraz

    2012-01-01

    OBJECTIVES: The International Narcotics Control Board released its 2005 annual report, highlighting the Brazil population as one of the largest consumers of anorectics. In Brazil, the National Health Surveillance Agency issued the resolution RDC 58/2007 in order to control the prescription and sale of such drugs. In Belém, the biggest city in the Brazilian Amazon region, this resolution came into force in 2008, leading to inspections of drugstores and magistral pharmacies. The aim of this wor...

  4. Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically.

    Science.gov (United States)

    Macmadu, Alexandria; Carroll, Jennifer J; Hadland, Scott E; Green, Traci C; Marshall, Brandon D L

    2017-05-01

    The rate of overdose deaths caused by fentanyl-contaminated heroin (FCH) use is increasing rapidly in the United States. We examined risk factors for exposure to FCH and experiences with FCH use among young adult non-medical prescription opioids (NMPO) users. We analyzed data from the Rhode Island Young Adult Prescription Drug Study (RAPiDS), which enrolled young adults aged 18 to 29 reporting prior 30day NMPO use between January 2015 and February 2016. Participants completed questionnaires ascertaining drug use patterns and risk behaviors, including FCH exposure. Logistic regression was used to assess factors associated with known or suspected FCH exposure. Of 199 participants, the median age was 25 (IQR: 22, 27), 130 (65.3%) were male, and 122 (61.3%) were of White, non-Hispanic race/ethnicity. In total, 22 (11%) reported known or suspected FCH exposure in the prior six months. Several drug use patterns and risk behaviors were associated with FCH exposure, including: regular heroin and cocaine use; diverted pharmaceutical fentanyl use in the prior six months; NMPO use to avoid withdrawal symptoms; longer duration of NMPO use; regular injection drug use; and prior overdose (all pfentanyl prior to last use, 59% reported that FCH provides a better high, and all recognized that fentanyl increases overdose risk. Exposure to fentanyl-contaminated heroin is an emerging trend among young adult NMPO users in Rhode Island. Overdose prevention programs addressing FCH use are urgently needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. PRODUCING NEW SALES MATERIAL FOR INTERNATIONAL SALES OF HOLIDAY CLUB KATINKULTA

    OpenAIRE

    Sipilä, Marjo

    2011-01-01

    The aim of this action based thesis was to create new sales material in English for international sales of Holiday Club Katinkulta. The material concentrates on the services offered in the spa hotel side. The spa hotel was sold to its former owner Holiday Club Resorts ltd during the thesis writing process and all sales material required updating after the ownership change. The new sales material is produced for the aid of daily sales work of sales representatives in the field of internati...

  6. [Attitudes toward insulin prescription in type 2 diabetic patients non-compliant with diet therapy].

    Science.gov (United States)

    Mordenti, F; D'Angiolini, G; Murgia, F

    2000-01-01

    Investigate the compliance of type 2 diabetic patients with the prescription of insulin according to pre-existing ideas on insulin, and to personality traits. Twenty insulin-treated type 2 diabetic patients were selected on the basis of previous scarce compliance with diet and exercise and BMI > 28 kg/m2. The patients' attitudes toward insulin prescription were evaluated with a semi-structured interview and personality traits were evaluated with the ACL test(Adjective Check List). When insulin was first prescribed to these patients, 65% accepted immediately. However, 45% answered that their acquiescence to insulin treatment was accompanied by doubts or apprehension. The fear of insulin dependence was shared by 50%, with a much greater prevalence among those who resisted to insulin treatment (86% vs 31%) and those who recalled doubts and fears about insulin (73% vs 22%). Patients with a fear of dependence differed significantly from the others in five personality scales: greater opposition and ambiguity, less self-confidence, more inflexible, less demanding of others and more inclined to bargain. The irrational fear of dependence may, therefore, play a role in both the manifest acceptance/rejection of insulin and non-expressed doubts, and may in turn be influenced by personality traits. Specific patient education on insulin treatment in type 2 diabetes is necessary, and should be planned according to the personality factors that may influence the perception of facts and the patients' motivation.

  7. Analysis of event logs from syringe pumps: a retrospective pilot study to assess possible effects of syringe pumps on safety in a university hospital critical care unit in Germany.

    Science.gov (United States)

    Kastrup, Marc; Balzer, Felix; Volk, Thomas; Spies, Claudia

    2012-07-01

    Medication errors occur in approximately one out of five doses in a typical hospital setting. Patients in the intensive care unit (ICU) are particularly susceptible to errors during the application of intravenous drugs as they receive numerous potent drugs applied by syringe pumps. The aim of this study was to analyse the effects on potential harmful medication errors and to address factors that have potential for improving medication safety after the introduction of a standardized drug library into syringe pumps with integrated decision support systems. A team of physicians and nurses developed a dataset that defined standardized drug concentrations, application rates and alert limits to prevent accidental overdosing of intravenous medications. This dataset was implemented in 100 syringe pumps with the ability to log programming errors, alerts, reprogramming events and overrides ('smart pumps'). In this retrospective pilot study, all pump-related transaction data were obtained from the pump logs, by downloading the data from the pumps, covering 20 months of use between 1 April 2008 and 30 November 2009. Patient data were gathered from the electronic patient charts. The study was performed in a cardiothoracic ICU of the Charité University Hospital, Berlin, Germany. A total of 7884 patient treatment days and 133,601 infusion starts were evaluated. The drug library with the features of the dose rate was used in 92.8% of the syringe pump starts, in 1.5% of the starts a manual dosing mode without the use of the drug library was used and in 5.7% of the starts the mode 'mL/h', without any calculation features, was used. The most frequently used drugs were vasoactive drugs, followed by sedation medication. The user was alerted for a potentially harmful overdosing in 717 cases and in 66 cases the pumps were reprogrammed after the alert. During the early morning hours a higher rate of alarms was generated by the pumps, compared with the rest of the day. Syringe pumps with

  8. Piling Pills? Forward-Looking Behavior and Stockpiling of Prescription Drugs

    DEFF Research Database (Denmark)

    Simonsen, Marianne; Skipper, Lars; Skipper, Niels

    This paper provides evidence of forward-looking behavior in the demand for prescription drugs, while relying on registry-based, individual-level information about the universe of Danish prescription drug purchases from 1995–2014. We exploit a universal shift in policy in early 2000 from a flat......-rate to a non-linear insurance plan for prescription drugs that incentivizes stockpiling at the end of the coverage year. We extend the original framework of Keeler et al. (1977) and discuss how the institutional features of most health insurance contracts, at least theoretically, incentivize intertemporal...... immediately prior to the end-of-year reset in the non-linear plan using a difference-in-difference strategy. We provide evidence that consumers react to this reset by stockpiling toward the end of the coverage year: consumers buy what amounts to an additional 20%. We detect heterogeneity in the size...

  9. Impact of Maryland's 2011 alcohol sales tax increase on alcoholic beverage sales.

    Science.gov (United States)

    Esser, Marissa B; Waters, Hugh; Smart, Mieka; Jernigan, David H

    2016-07-01

    Increasing alcohol taxes has proven effective in reducing alcohol consumption, but the effects of alcohol sales taxes on sales of specific alcoholic beverages have received little research attention. Data on sales are generally less subject to reporting biases than self-reported patterns of alcohol consumption. We aimed to assess the effects of Maryland's July 1, 2011 three percentage point increase in the alcohol sales tax (6-9%) on beverage-specific and total alcohol sales. Using county-level data on Maryland's monthly alcohol sales in gallons for 2010-2012, by beverage type, multilevel mixed effects multiple linear regression models estimated the effects of the tax increase on alcohol sales. We controlled for seasonality, county characteristics, and national unemployment rates in the main analyses. In the 18 months after the tax increase, average per capita sales of spirits were 5.1% lower (p sales were 3.2% lower (p sales were 2.5% lower (p sales trends in the 18 months prior to the tax increase. Overall, the alcohol sales tax increase was associated with a 3.8% decline in total alcohol sold relative to what would have been expected based on sales in the prior 18 months (p increased alcohol sales taxes may be as effective as excise taxes in reducing alcohol consumption and related problems. Sales taxes also have the added advantages of rising with inflation and taxing the highest priced beverages most heavily.

  10. Comparison between syringe irrigation and RinsEndo in reduction of Enterococcus faecalis in experimentally infected root canal

    Directory of Open Access Journals (Sweden)

    Sharareh Mousavi Zahed

    2015-05-01

    Full Text Available Background and Aims: To ensure root canal treatment success, endodontic microbiota should be efficiently reduced. Several irrigation devices have been recently introduced with the main objective of improving root canal disinfection.The purpose of this study was to evaluate the rinsing effect of RinsEndo system in reduction of enterococcus faecalis in comparison with conventional hand syringe in infected root canals.   Materials and Methods: 60 extracted single canal anterior teeth were infected with enterococcus faecalis and divided into 3 groups: RinsEndo system, conventional hand syringe and control group. The enterococcus faecalis colonies were counted in each group before and after rinsing. Data were analyzed using Variance and Kruskal Wallis test.   Results: The mean of enterococcus faecalis growth after rinsing was 3.50×103 in group with conventional syring rinsing, 2.04×103 in group with RinsEndo washing and 6.11×103 in control group. Reduction of enterococcus faecalis after rinsing was statistically significant in each group (P<0.001. The amount of reduction in number of colonies with RinsEndo and conventional syringe rinsing was higher in comparison with control group and this difference was significant (P<0.001. RinsEndo rinsing effect was statistically significantly higher in comparison to conventional syringe as well (P<0.001.   Conclusion: Rinsing with RinsEndo system was significantly more efficient in reduction of enterococcus faecalis from root canal in comparison with hand syringe washing.

  11. 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.

  12. Analysis of costs to dispense prescriptions in independently owned, closed-door long-term care pharmacies.

    Science.gov (United States)

    Carroll, Norman V; Rupp, Michael T; Holdford, David A

    2014-03-01

    developed to examine the impact of shorter dispensing cycles on LTC pharmacies' CTD. A prescription volume increase of 19% was assumed based on converting only solid oral branded drugs to short-cycle dispensing. A diverse sample of 64 closed-door LTC pharmacies returned usable surveys. Sales from dispensing to LTC facilities accounted for more than 98% of total sales. Respondents indicated that they currently dispensed 23% of total doses in 14-day-or-less cycles and 76% in 28-31 day cycles. Most pharmacies used automated medication packaging technology, heat and cold package sealers, bar code systems, sterile compounding hoods, LTC printers or labelers, and electronic prescribing. The median CTD was $13.54 with an interquartile range (25th to 75th percentiles) of $10.51 to $17.66. More than half of dispensing-related costs were from personnel expense, of which pharmacists and managers accounted for more than 40%. The results of the fixed and variable cost modeling suggested that converting solid oral brand-name drugs from 30-day to 14-day dispensing cycles would lower the median per prescription CTD to between $11.63 and $12.54, depending on the assumptions made about the effects of semivariable costs. However, this decrease in per prescription dispensing cost is dwarfed by an increase in total dispensing cost incurred by pharmacies that results from doubling the monthly volume of short-cycle prescriptions that must be dispensed. The result is that the typical LTC pharmacy in our sample incurred a CTD of $13.54 if the medication is dispensed in a 30-day cycle or $23.26 if the medication is dispensed in two 14-day cycles (at a cost of $11.63 for each cycle dispensed). Our results indicated a median CTD of $13.54 for the typical independently owned, closed-door LTC pharmacy. Moving to a shorter cycle would reduce pharmacies' average per-prescription CTD but would increase the number of prescriptions dispensed per month. Our results indicated that transitioning solid oral

  13. Exercise prescription for patients with non-specific chronic low back pain: a qualitative exploration of decision making in physiotherapy practice.

    Science.gov (United States)

    Stenner, Rob; Swinkels, Annette; Mitchell, Theresa; Palmer, Shea

    2016-12-01

    Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. A qualitative study using a philosophical hermeneutic approach. Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. The findings revealed how physiotherapy practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists' assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) which exercise? - the tension between evidence and everyday practice and (3) compliance-orientated more than concordance based. This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  14. Sales skills for health-care professionals: the emotional side of sales.

    Science.gov (United States)

    Nigon, D L

    2001-01-01

    Health-care sales continues to be an area of opportunity for many laboratory professionals. For those who possess the necessary skills and the desire to enthusiastically embrace the unique challenges of a sales career, a new CLMA publication by CLMR contributor Donna L. Nigon, MT(ASCP), titled Sales Skills for Health-Care Professionals, will provide the knowledge of sales structure and techniques needed to succeed. This Sales Skills excerpt, "The Emotional Side of Sales," describes many of the emotional aspects of sales and selling, including how to handle the transition from a technical or medical role to that of sales representative, relationship building, maintaining personal and professional support systems, dealing with rejection, avoiding burnout, time management, and customer concerns. For more information about this book, please see the order form that accompanies this excerpt, or visit www.clma.org.

  15. 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

  16. Slowing Menthol's Progress: Differential Impact of a Tobacco Tax Increase on Cigarette Sales.

    Science.gov (United States)

    Amato, Michael S; D'Silva, Joanne; Boyle, Raymond G

    2016-05-01

    The proportion of smokers who use menthol cigarettes has increased nationally since 2004, while use of non-menthol cigarettes is declining, suggesting that menthol may be undermining the effectiveness of population level tobacco control efforts. In 2013 Minnesota passed a $1.75 cigarette tax increase. We investigated whether sales of menthol and non-menthol cigarettes were differentially affected by the price increase. Cigarette sales data from convenience stores in the Minneapolis, Minnesota, metro area from January 2012, through May 2015, were obtained. Proportion of sales accounted for by menthol cigarettes was analyzed with segmented regression. Before the price increase, menthol cigarettes gained 2.21% (1.17, 3.12) of market share annually. Following the price increase, the trend slowed to 0.26% (-0.78, 1.56) annually. The slope before the price increase was significantly positive; the slope following the price increase did not significantly differ from zero. Sales of menthol cigarettes declined less rapidly than non-menthol cigarettes before the price increase. Sales of menthol and non-menthol cigarettes declined at more comparable rates after the price increase. Increasing the price of tobacco may help ensure declines in consumption are more evenly distributed across menthol and non-menthol cigarettes. Using sales data, we found that a trend of increasing market share for menthol cigarettes was significantly reduced by a $1.75 cigarette price increase. These results suggest that cigarette price increases, a core tobacco control policy, may have a greater effect on menthol smokers than non-menthol smokers. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Iloprost infusion by a new device as a portable syringe pump: safety, tolerability and agreement

    Directory of Open Access Journals (Sweden)

    Paola Faggioli

    2012-12-01

    Full Text Available Background Iloprost, prostacyclin (PGI2 analogue, effective in treatment of peripheral arterial disease, secondary Raynaud's phenomenon (RP to connective tissue disease (CTD, vasculitis, pulmonary hypertension, is usually infused through peristaltic pump, or recently through a flow regulator.Materials and methods We tested a new portable syringe pump (Pompa Infonde®, Italfarmaco S.p.A., Cinisello Balsamo, Milano on 120 patients affected by RP to CTD and cryoglobulinaemia, in iloprost therapy with a flow regulator.Results Iloprost infused through portable syringe pump is better tolerated, better appreciated by the patients and nurses and no difference was observed on therapeutic effects, with a lower incidence of side effects statistically significant. Only 3 patients were unable to tolerate the device (2 for changes in pressure and 1 for fear and shifted to traditional method of iloprost infusion.Conclusions Iloprost infusion through the portable syringe Pompa Infonde® appears to be safe, better tolerated, more acceptable and equally effective compared to infusion through a flow regulator.

  18. Point of sale tobacco advertisements in India.

    Science.gov (United States)

    Chaudhry, S; Chaudhry, S; Chaudhry, K

    2007-01-01

    The effect of any legislation depends on its implementation. Limited studies indicate that tobacco companies may tend to use such provision for surrogate advertising. The point of sale advertisement provision has been placed in the Indian Tobacco Control legislation. The study was undertaken to assess the Indian scenario in this regard. To assess if there are any violations related to provision of point of tobacco sale advertisements under India's comprehensive tobacco Control legislation in different parts of India. Boards over various shops showing advertisements of tobacco products were observed in the cities of Delhi, Mumbai, Kolkata, Trivandrum and Jaipur, between September 2005 and March 2006. The point of sale advertisements mushroomed after the implementation of 2004 tobacco control legislation. Tobacco advertisement boards fully satisfying the point of sale provision were practically non-existent. The most common violation of point of sale advertisements was the larger size of the board but with tobacco advertisement equal to the size indicated in the legislation and remaining area often showing a picture. Invariably two boards were placed together to provide the impression of a large single repetitive advertisement. More than two boards was not common. Tobacco advertisement boards were also observed on closed shops/ warehouses, shops not selling tobacco products and on several adjacent shops. The purpose of the point of sale advertisements seems to be surrogate advertisement of tobacco products, mainly cigarettes.

  19. Evaluation of non-linear blending in dual-energy computed tomography

    International Nuclear Information System (INIS)

    Holmes, David R.; Fletcher, Joel G.; Apel, Anja; Huprich, James E.; Siddiki, Hassan; Hough, David M.; Schmidt, Bernhard; Flohr, Thomas G.; Robb, Richard; McCollough, Cynthia; Wittmer, Michael; Eusemann, Christian

    2008-01-01

    Dual-energy CT scanning has significant potential for disease identification and classification. However, it dramatically increases the amount of data collected and therefore impacts the clinical workflow. One way to simplify image review is to fuse CT datasets of different tube energies into a unique blended dataset with desirable properties. A non-linear blending method based on a modified sigmoid function was compared to a standard 0.3 linear blending method. The methods were evaluated in both a liver phantom and patient study. The liver phantom contained six syringes of known CT contrast which were placed in a bovine liver. After scanning at multiple tube currents (45, 55, 65, 75, 85, 95, 105, and 115 mAs for the 140-kV tube), the datasets were blended using both methods. A contrast-to-noise (CNR) measure was calculated for each syringe. In addition, all eight scans were normalized using the effective dose and statistically compared. In the patient study, 45 dual-energy CT scans were retrospectively mixed using the 0.3 linear blending and modified sigmoid blending functions. The scans were compared visually by two radiologists. For the 15, 45, and 64 HU syringes, the non-linear blended images exhibited similar CNR to the linear blended images; however, for the 79, 116, and 145 HU syringes, the non-linear blended images consistently had a higher CNR across dose settings. The radiologists qualitatively preferred the non-linear blended images of the phantom. In the patient study, the radiologists preferred non-linear blending in 31 of 45 cases with a strong preference in bowel and liver cases. Non-linear blending of dual energy data can provide an improvement in CNR over linear blending and is accompanied by a visual preference for non-linear blended images. Further study on selection of blending parameters and lesion conspicuity in non-linear blended images is being pursued

  20. Feasibility of Using Fluorescence Spectrophotometry to Develop a Sensitive Dye Immersion Method for Container Closure Integrity Testing of Prefilled Syringes.

    Science.gov (United States)

    Lu, Xujin; Lloyd, David K; Klohr, Steven E

    2016-01-01

    A feasibility study was conducted for a sensitive and robust dye immersion method for the measurement of container closure integrity of unopened prefilled syringes using fluorescence spectrophotometry as the detection method. A Varian Cary Eclipse spectrofluorometer was used with a custom-made sample holder to position the intact syringe in the sample compartment for fluorescence measurements. Methylene blue solution was initially evaluated as the fluorophore in a syringe with excitation at 607 nm and emission at 682 nm, which generated a limit of detection of 0.05 μg/mL. Further studies were conducted using rhodamine 123, a dye with stronger fluorescence. Using 480 nm excitation and 525 nm emission, the dye in the syringe could be easily detected at levels as low as 0.001 μg/mL. The relative standard deviation for 10 measurements of a sample of 0.005 μg/mL (with repositioning of the syringe after each measurement) was less than 1.1%. A number of operational parameters were optimized, including the photomultiplier tube voltage, excitation, and emission slit widths. The specificity of the testing was challenged by using marketed drug products and a protein sample, which showed no interference to the rhodamine detection. Results obtained from this study demonstrated that using rhodamine 123 for container closure integrity testing with in-situ (in-syringe) fluorescence measurements significantly enhanced the sensitivity and robustness of the testing and effectively overcame limitations of the traditional methylene blue method with visual or UV-visible absorption detection. Ensuring container closure integrity of injectable pharmaceutical products is necessary to maintain quality throughout the shelf life of a sterile drug product. Container closure integrity testing has routinely been used to evaluate closure integrity during product development and production line qualification of prefilled syringes, vials, and devices. However, container closure integrity testing

  1. Conformity of Goods in International Sales

    DEFF Research Database (Denmark)

    Henschel, Rene Franz

    The Conformity of Goods in International Sales gives a systematic analysis of Article 35 in the United Nations Convention on Contracts for the International Sale of Goods (CISG). Based on a detailed analysis of the most important cases and leading academic writing, Article 35 is described...... 9 CISG and the UNIDROIT Principles of International Commercial Contracts. The relation to domestic rules competing with Article 35, for instance the rules on validity and the rules on non-contractual liability, are analysed and so is the relation to selected domestic sales law, e.g. the United...... as a historical compromise between caveat emptor and caveat venditor and it is shown that the Article is to be supplemented by the general rules of contract law inside and outside the convention, such as the principle of good faith in Article 7 CISG, the rules of interpretation and usage in Article 8 and Article...

  2. Sales Force Recruitment

    OpenAIRE

    Flaviu MEGHISAN

    2008-01-01

    The sales plan is put into practice through the tasks associated with sales plan implementation. Whereas sales plan formulation focuses on "doing the right things," implementation emphasizes "doing things right." The three major tasks involved in implementing a sales plan are (1) salesforce recruitment and selection, (2) salesforce training, and (3) salesforce motivation and compensation.

  3. Non-medical use of prescription drugs among illicit drug users: A case study on an online drug forum.

    Science.gov (United States)

    Rönkä, Sanna; Katainen, Anu

    2017-01-01

    The non-medical use of prescription drugs is a growing phenomenon associated with increasing health-related harms. However, little is known about the drivers of this process among illicit drug users. Our aim is to show how the qualities of pharmaceutical drugs, pharmaceutical related knowledge, online communities sharing this knowledge and medical professionals mediate and transform the consumption behaviour related to pharmaceutical drugs. The data consist of discussion threads from an online drug use forum. Using actor network theory (ANT), we analysed translations that mediate the online user community's relationship with pharmaceutical drugs. Differences in experienced drug effects are explained both as a process of 'learning' and as differences in brain chemistry at the receptor level. Both science- and experience-based information are shared on best practices to optimise use, avoid adverse health effects and maximise the experience of intoxication. The expanded context of doctors' practices places stress on the medical framework for drug use. Our analysis shows how the non-medical use of psychoactive pharmaceuticals relates to joint, medicalised ideas of bodies as sites of medical experimentation, as well as to the collective process of constructing 'pharmaceutical competences' in user networks. Understandings of intoxication have increasingly been permeated with the pharmacological and scientific logic of knowledge. The forum works as a platform for harm reduction inspired exchange of knowledge. However, the user community's knowledge sharing practices can generate a shared perception of a sufficient or even superior drug use experience and knowledge. This may lead to overdoses and other risky behaviour, and thereby contribute to increased harms related to non-medical use of prescription drugs. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Partnership for Prescription Assistance

    Science.gov (United States)

    ... 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 ...

  5. Costs of a Hospital-Based, Ready-To-Use Syringe Delivery Programme

    DEFF Research Database (Denmark)

    Risør, Bettina Wulff; Vand, S; Lisby, M

    2017-01-01

    %) and at €20,905 (an increase of 228%) for the endoscopy department. The ready-to-use delivery program imposed an additional cost of €11.32 per day surgery operation and €2.41 per endoscopy procedure. Conclusion: This ready-to-use programme increased the cost of the medical handling process. This incremental......Objective: The risk of errors in the medication administration process is high. Applications of pre lled syringes may improve patient safety but could be more costly. The objective of this study was to assess the additional costs of a ready-to-use syringe delivery programme in comparison...... with a conventional delivery programme at day surgery and endoscopy departments at a large university hospital. Methods: The cost analysis used the hospital perspective and developed an “activity-based costing” model to assess the costs of medicine- handling activities. The model was calibrated with six-month data...

  6. [Prescription annotations in Welfare Pharmacy].

    Science.gov (United States)

    Han, Yi

    2018-03-01

    Welfare Pharmacy contains medical formulas documented by the government and official prescriptions used by the official pharmacy in the pharmaceutical process. In the last years of Southern Song Dynasty, anonyms gave a lot of prescription annotations, made textual researches for the name, source, composition and origin of the prescriptions, and supplemented important historical data of medical cases and researched historical facts. The annotations of Welfare Pharmacy gathered the essence of medical theory, and can be used as precious materials to correctly understand the syndrome differentiation, compatibility regularity and clinical application of prescriptions. This article deeply investigated the style and form of the prescription annotations in Welfare Pharmacy, the name of prescriptions and the evolution of terminology, the major functions of the prescriptions, processing methods, instructions for taking medicine and taboos of prescriptions, the medical cases and clinical efficacy of prescriptions, the backgrounds, sources, composition and cultural meanings of prescriptions, proposed that the prescription annotations played an active role in the textual dissemination, patent medicine production and clinical diagnosis and treatment of Welfare Pharmacy. This not only helps understand the changes in the names and terms of traditional Chinese medicines in Welfare Pharmacy, but also provides the basis for understanding the knowledge sources, compatibility regularity, important drug innovations and clinical medications of prescriptions in Welfare Pharmacy. Copyright© by the Chinese Pharmaceutical Association.

  7. Determining serum bicarbonate; a simple syringe titrator and colorimeter.

    Science.gov (United States)

    BOONE, C W; FIELD, J B

    1953-12-01

    The use of a tuberculin syringe as a burette has made possible an easy bedside technique for the determination of serum bicarbonate. By combining it with the use of a simple colorimeter, a relatively untrained person can do numerous bicarbonate determinations with a high degree of accuracy. The same technique also lends itself to other colorimetric clinical procedures such as determination of gastric acidity.

  8. DETERMINING SERUM BICARBONATE—A Simple Syringe Titrator and Colorimeter

    Science.gov (United States)

    Boone, Charles W.; Field, John B.

    1953-01-01

    The use of a tuberculin syringe as a burette has made possible an easy bedside technique for the determination of serum bicarbonate. By combining it with the use of a simple colorimeter, a relatively untrained person can do numerous bicarbonate determinations with a high degree of accuracy. The same technique also lends itself to other colorimetric clinical procedures such as determination of gastric acidity. PMID:13106724

  9. Are bans on kidney sales unjustifiably paternalistic?

    Science.gov (United States)

    Malmqvist, Erik

    2014-03-01

    This paper challenges the view that bans on kidney sales are unjustifiably paternalistic, that is, that they unduly deny people the freedom to make decisions about their own bodies in order to protect them from harm. I argue that not even principled anti-paternalists need to reject such bans. This is because their rationale is not hard paternalism, which anti-paternalists repudiate, but soft paternalism, which they in principle accept. More precisely, I suggest that their rationale is what Franklin Miller and Alan Wertheimer call 'group soft paternalism'. Group soft paternalistic policies restrict the freedom of autonomous individuals, not for their own good (hard paternalism), but as an unavoidable consequence of seeking to protect other, non-autonomous individuals from harms that they have not voluntarily chosen (soft paternalism). Group soft paternalism supports prohibiting kidney sales on three conditions: (1) that such sales are potentially harmful to vendors, (2) that many vendors would suffer impaired autonomy, and (3) that distinguishing between autonomous and non-autonomous vendors and interfering only with the latter is unfeasible. I provide reasons for thinking that these conditions will often hold. © 2012 John Wiley & Sons Ltd.

  10. Professional ideologies and the development of syringe exchange: Wales as a case study.

    Science.gov (United States)

    Keene, J M; Stimson, G V

    1997-12-01

    This paper is derived from an evaluative study of HIV prevention programs for drug injectors across Wales. It considers how different professional territories and ideologies, concepts of drug misuse and models of HIV prevention may influence policy development. The research involved monitoring the introduction and development of agency and community based syringe exchange schemes and initiatives taken by community pharmacists. Interviews with staff, managers and administrators, and descriptions of service history, development and delivery inform the discussion. HIV prevention varied in different areas of Wales depending on the particular professional group involved, local ideologies regarding drug use treatment, and the extent to which HIV prevention was seen either as a specialist area of expertise and specific remit of drug workers or a generic health care task. Drug agencies with an abstinence policy rejected syringe exchange; instead, prevention in those areas developed in ad hoc ways as health care workers and pharmacists attempted to develop a community based service. Drug agencies with a pre-existing harm minimisation model easily integrated syringe exchange into their work and played the major part in establishing the service, but there was difficulty in extending it beyond their professional caseloads. As there were disincentives to use treatment agencies, and their catchment areas were limited, these factors influenced effective service provision.

  11. Audit report on GDF Suez's supply costs and non-supply related costs in natural gas regulated sale tariffs - May 2014

    International Nuclear Information System (INIS)

    2014-05-01

    After having recalled the legal context of objectives of this audit performed by the French Commission for Energy Regulation (CRE), this report proposes an analysis of GDF Suez's dissociated accounting which showed that costs are covered by natural gas regulated sale tariffs. In the second part, it comments the current market indexing used in tariff formula, comments current and present negotiations and their consequences for the market indexing share in long term contracts, discusses the issue of tariff volatility related to an increased market indexing share, discusses the possible re-examination of indices at the occasion of formula reviewing, and outlines that the diversified supplier portfolio allows optimisation operations. The third part addresses non-supply related costs: evolution of different infrastructure costs (related to distribution, transport, and storage) to be taken into account in regulated sale tariffs, evolution of commercial costs. Some recommendations are then made regarding the perspective of a tariff formula revision, and the perspectives of evolution of non-supply related costs

  12. Indagine sulle condizioni ambientali delle sale operatorie

    Directory of Open Access Journals (Sweden)

    U. Moscato

    2003-05-01

    Full Text Available

    Obiettivi: l’esigenza di uno studio conoscitivo sull’attuale situazione dei reparti e delle sale operatorie in Italia nasce dalla necessità di ottenere le informazioni e valutare le risorse utili per la definizione di effettivi requisiti minimi o livelli minimi assistenziali. L’esigenza, inoltre, di procedure e di protocolli standardizzati ai fini della prevenzione e della tutela del personale e del degente, rappresentano altrettante istanze e finalità da cui trae origine lo studio in oggetto.

    Metodi: un questionario, composto da 186 domande a risposta multipla “chiusa”, è stato somministrato come studio pilota in circa 30 presidi ospedalieri sul territorio italiano. Attualmente è in fase di svolgimento lo studio finale, con la somministrazione del questionario alla maggior parte dei presidi ospedalieri pubblici e privati in ambito regionale. Il questionario è suddiviso in più parti compilabili separatamente: una comune riferita all’analisi di tutto il Blocco Operatorio ed una da compilarsi per ogni Sala Operatoria del Blocco. Sono rilevate informazioni sulle caratteristiche strutturali ed impiantistiche degli ambienti; sulla gestione, manutenzione ed il controllo di efficacia degli impianti e sui campionamenti eseguiti. Vengono analizzate anche l’organizzazione, l’informazione e la formazione del personale; nonché le condizioni igieniche, la disinfezione e l’efficacia del processo di sterilizzazione.

    Risultati: il 79% delle sale operatorie attualmente verificate non sono in possesso di accreditamento e/o certificazione, mentre il 50% non ha né certificato di prevenzione incendi né nulla osta provvisorio. Il 24% delle sale operatorie non possiede “sgusci” a pavimento per la sanitizzazione ambientale. L’89% delle strutture sanitarie non possiede sistemi di “rintracciabilità” del prodotto sterilizzato o, nel 39% dei casi, protocolli o procedure

  13. Direct-to-consumer promotion of prescription drugs. Economic implications for patients, payers and providers.

    Science.gov (United States)

    Findlay, S D

    2001-01-01

    Spending on outpatient prescription drugs in the US is accelerating rapidly. Although numerous factors are driving this trend, attention has recently focused on the role played by the marketing, promotion and advertising of pharmaceuticals, in particular direct-to-consumer (DTC) advertising. In 1997, the US Food and Drug Administration (FDA) issued a 'guidance' on such mass media promotion. The guidance altered existing FDA rules and effectively permitted pharmaceutical companies to promote prescription drugs on television and radio without giving detailed or even summary information on indications, efficacy or potential adverse effects. Since then, television commercials, in particular, and print advertisements in consumer magazines and newspapers have proliferated rapidly. Pharmaceutical companies spent $US1.8 billion on DTC advertising in 1999, a 40% increase over 1998. This spending in 1999 was heavily concentrated on about 50 drugs. Evidence is growing that DTC promotion of prescription drugs is: (i) alerting consumers to the existence of new drugs and the conditions they treat; (ii) increasing consumer demand for many drugs; (iii) contributing increasingly to the recent sharp increase in the number of prescriptions being dispensed; (iv) raising sales revenues; and, thus, (v) contributing to the higher pharmaceutical costs of health insurers, government and consumers. The public policy issues surrounding DTC advertisements centre on the following questions: (i) are the advertisements leading to the inappropriate clinical use of some drugs? (ii) are the advertisements inducing both consumers and physicians to choose more costly new brand-name drugs over less expensive, but equally effective, older brand or generic drugs? (iii) do television advertisements for prescription drugs contain a balanced amount of information on benefits versus potential adverse effects? and (iv) will the revenue benefits generated by DTC advertising cause pharmaceutical companies to

  14. 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.

  15. Auction Sale Data

    Data.gov (United States)

    General Services Administration — This dataset contains sale data information for Agency reported items sold via GSA Auctions® Sales. The data is for closed sales during FY2009. GSA Auctions® offers...

  16. INNOVATIVE SALES METHODS

    Directory of Open Access Journals (Sweden)

    Roxana L. IONESCU

    2014-06-01

    Full Text Available Companies operating in a global economy that is constantly changing and developming, especially during the financial crisis and political instability. It is necessary to adapt and develop sales methods in such environment. For large companies who base their activity on sales it has become a necessity to learn different types of sales approaches because their knowledge enables them to grow the number of customers and therefore the sales and the turnover. This paper aims to exame the most effective sales methods used on the highly sensitive economic and social environment – the insurance market. In the field of insurances, the sales process is even more important because sellers need to sell an intangible product that may materialize in the future, but there is no certainty.

  17. Clinical introduction of Monte Carlo treatment planning: A different prescription dose for non-small cell lung cancer according to tumor location and size

    International Nuclear Information System (INIS)

    Voort van Zyp, Noelle C. van der; Hoogeman, Mischa S.; Water, Steven van de; Levendag, Peter C.; Holt, Bronno van der; Heijmen, Ben J.M.; Nuyttens, Joost J.

    2010-01-01

    Purpose: To provide a prescription dose for Monte Carlo (MC) treatment planning in patients with non-small-cell lung cancer according to tumor size and location. Methods: Fifty-three stereotactic radiotherapy plans designed using the equivalent path-length (EPL) algorithm were re-calculated using MC. Plans were compared by the minimum dose to 95% of the PTV (D95), the heterogeneity index (HI) and the mean dose to organs at risk (OARs). Based on changes in D95, the prescription dose was converted from EPL to MC. Based on changes in HI, we examined the feasibility of MC prescription to plans re-calculated but not re-optimized with MC. Results: The MC fraction dose for peripheral tumors is 16-18 Gy depending on tumor size. For central tumors the MC dose was reduced less than for peripheral tumors. The HI decreased on average by 4-9% in peripheral tumors and 3-5% in central tumors. The mean dose to OARs was lower for MC than EPL, and correlated strongly (R 2 = 0.98-0.99). Conclusion: For the conversion from EPL to MC we recommend a separate prescription dose according to tumor size. MC optimization is not required if a HI ≥ 70% is accepted. Dose constraints to OARs can be easily converted due to the high EPL-MC correlation.

  18. Chronic non-cancer pain and the epidemic prescription of opioids in the Danish population

    DEFF Research Database (Denmark)

    Birke, H; Kurita, G P; Sjøgren, P

    2016-01-01

    of benzodiazepine (BZD)/BZD-related drugs in the Danish population. METHODS: Data from the cross-sectional national representative Danish Health and Morbidity Surveys (2000, 2005, 2010, and 2013) were combined with The Danish National Prescription Registry at an individual level. The study populations varied...... prevalence of opioid use from 4.1% to 5.7% among CNCP individuals. Higher CNCP prevalence was related to female gender, no cohabitation partner, short education, non-Western origin, and overweight/obesity. In addition, women with CNCP, especially >65 years, became more frequent users of opioids and used...... higher doses than men. Concurrent use of BZD/BZD-related drugs decreased (13%) from 2010 to 2013, still one-third of long-term opioid user were co-medicated with these drugs. CONCLUSIONS: The use of opioids has increased in Denmark, especially among elderly women. The concurrent use of BZD...

  19. Non-medical use of prescription pain relievers among high school students in China: a multilevel analysis.

    Science.gov (United States)

    Guo, Lan; Xu, Yan; Deng, Jianxiong; He, Yuan; Gao, Xue; Li, Pengsheng; Wu, Hong; Zhou, Jinhua; Lu, Ciyong

    2015-07-13

    Given the differences between general high school (GHS) and vocational high school (VHS) students, this study aimed to investigate the lifetime prevalence of non-medical use of prescription pain relievers (NMUPPR) among high school students as well as the associations between NMUPPR and individual-level factors and school category. A cross-sectional study was conducted in GHS and VHS students in 2012 in Chongqing, and 11 906 students' questionnaires were completed and qualified for the survey. Self-reported NMUPPR and information regarding individual-level determinants and school category were collected. A multilevel multivariate logistic regression model was fitted to explore independent predictors of NMUPPR. The total lifetime prevalence of NMUPPR was 11.3%, and NMUPPR was more prevalent among VHS students (15.8%) compared with GHS students (9.8%). Overall, the results indicated that VHS students were more likely to be involved in NMUPPR (adjusted OR (AOR)=1.64, 95% CI 1.42 to 1.89). Regarding the individual-level predictors of NMUPPR, below-average family economic status was negatively correlated with NMUPPR (AOR=0.77, 95% CI 0.60 to 0.98), and students with more pocket money were more likely to be engaged in NMUPPR. Students who had difficult family relationships, had poor relationships with teachers, had parents or friends who engaged in non-medical prescription drug use, and considered or attempted suicide were more likely to be engaged in NMUPPR. NMUPPR among high school students is a multidetermined phenomenon. The current findings indicate that VHS students are an important subgroup of adolescents and highlight the need for additional research as well as targeted prevention and intervention programmes for NMUPPR. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. 'You've got m@il: fluoxetine coming soon!': accessibility and quality of a prescription drug sold on the web.

    Science.gov (United States)

    Gelatti, U; Pedrazzani, R; Marcantoni, C; Mascaretti, S; Repice, C; Filippucci, L; Zerbini, I; Dal Grande, M; Orizio, G; Feretti, D

    2013-09-01

    The increasing phenomenon of online pharmacies has potential for serious public health problems. This study aimed to evaluate the possibility of accessing a prescription drug in the absence of a prescription for an Italian purchaser. Fluoxetine pills were ordered from several online pharmacies. The study included website analysis, and the quality of the received product including packaging, chemical and microbiological analyses. Orders could be placed correctly on 61 of the 98 selected websites, and a sales transaction was concluded successfully on 17 websites. Thirteen drug samples were eventually received. In one case it was necessary to fill in a questionnaire before ordering the drugs. All websites displayed aggressive marketing strategies. There was wide variation in terms of domain registration, company base (when declared) and manufacturer's location (mostly India). All pills were delivered in sealed blister packs showing the lot number and manufacturer's details. A leaflet was enclosed in one case only. In three cases we received more pills than ordered, and in one case Viagra pills as a free gift. Pharmacopoeia microbiological requirements were satisfied. Chemical analysis revealed that the active principle was always present, although many samples did not meet the Pharmacopoeia "other impurities" or "total impurities" criteria. Heavy metals and solvents regulated by the Pharmacopoeia did not exceed the set limits; some of the non-regulated ones were also assessed, in some cases with a positive result (e.g. styrene). About 20% of purchase attempts resulted in delivery of the drugs, even in the absence of a medical prescription. Traceability was poor and drug quality was generally worse compared to conventional pharmacy-purchased products. Based on all these broad-spectrum results, user safety appears not to be globally guaranteed. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. Gas ampoule-syringe

    International Nuclear Information System (INIS)

    Gay, D.D.

    1986-01-01

    This patent describes disposable gas ampoule holding or containing a gas such as a radioactive gas, comprising: (a) a cylindrical glass tube which is adapted to hold the gas; (b) a layer of absorbent material which circumscribes and which contacts cylindrical glass tube (a) which absorbs the gas; (c) a plastic tube, which circumscribes and contacts absorbent material layer (b) and which is externally threaded on each of its end portions; (d) a cap, which is threaded onto a first end of plastic tube (c); (e) a cylindrical block, which is positioned in the first end of cylindrical glass tube (a) adjacent to cap (d), which contacts cylindrical glass tube (a), which is composed of a foamed material and which is impregnated with a gas adsorbent material; (f) a cylindrical plunger tip, which is located in the first end of cylindrical glass tube (a) in a gas-tight manner adjacent to cylindrical block (e); (g) an end stopper, which has a central cylindrical shaft that is positioned in the second end of cylindrical glass tube (a); and (h) a cap, which is threaded onto the second end of plastic tube (e). A combination of the disposable gas ampoule and syringe adapted to operably interface with the gas ampoule is also described

  2. 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, ...

  3. Editorial: Sales Strategy (2010

    Directory of Open Access Journals (Sweden)

    Chris McPhee

    2010-09-01

    Full Text Available The editorial theme for this issue of the OSBR is Sales Strategy. While "marketing" is everything a company does to build interest in its offers, "sales" consists of converting these offers into cash. By "sales strategy," we refer to all sales planning and process development activities leading up to the actual selling of a product or service. In his recent blog post at MaRS Discovery District, Mark Zimmerman answered a question he is frequently asked by the founders of startups: "How do we find a good sales person?" In short, his answer is "Don't." This is not meant as a slight to sales professionals, but rather, Zimmerman is advocating that companies should not equate having sales professionals to having a sales strategy. Sales professionals have a critical role to play in a company's success, but they are being given an impossible task if asked to sell something that has not been validated with customers. Zimmerman explains that sales professionals should be hired only once a company has validated that the value proposition resonates with customers and that the sales model will be effective. This lesson also applies to established companies, where existing sales staff require this same foundation to be effective. So how does a company determine whether its value proposition resonates with customers? The answer, of course, is to talk to customers. In the OSBR and elsewhere, the need for early customer input is a dominant theme in recent discussions of product development, marketing, and now sales strategy. By talking to customers, listening to how they describe their needs, and interpreting how their needs could be met, a value proposition can tested and refined. It is far more efficient and effective to iteratively refine a value proposition before attempting to sell than to attempt a salvage operation in response to slumping sales. Customer input is also a critical ingredient in developing an effective sales strategy. In this issue of the

  4. Future Challenges and Opportunities in Online Prescription Drug Promotion Research; Comment on “Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters”

    Directory of Open Access Journals (Sweden)

    Brian G. Southwell

    2016-03-01

    Full Text Available 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.

  5. 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

  6. revenue management–sales relationship

    OpenAIRE

    Noone, B. M; Hultberg, T.

    2011-01-01

    Revenue management and sales staffs collaborate substantially in making decisions regarding rate setting, accepting group business, and forecasting. However, according to a survey of 82 sales and revenue management executives at three hotel chains (47 revenue managers and 35 sales executives), hotels could foster even better coordination between revenue management and sales by educating each group regarding the other group’s responsibilities. This might reduce sales staff frustrations about t...

  7. Fire Sales and House Prices

    DEFF Research Database (Denmark)

    Andersen, Steffen; Meisner Nielsen, Kasper

    We exploit a natural experiment in Denmark to investigate when forced sales lead to fire sale discounts. Forced sales result from sudden deaths of house owners in an institutional environment in which beneficiaries are forced to settle the estate, and hence sell the house, within 12 months. We...... and the urgency of the sale also affect the average discount: Discounts are larger when house prices contract, in thin markets where demand is lower, and when the sale is more likely to be a fire sale because of financial or liquidity constraints. Late fire sales are more likely when the house price...... forced sales lead to fire sale discounts....

  8. The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

    Directory of Open Access Journals (Sweden)

    Carla Treloar

    Full Text Available A formal Needle and Syringe Program (NSP is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV risk and risk mitigation opportunities for inmates.The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons.A needle/syringe was nominated as being typically priced in the 'inside' prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment "quiet", stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison.The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

  9. The Prison Economy of Needles and Syringes: What Opportunities Exist for Blood Borne Virus Risk Reduction When Prices Are so High?

    Science.gov (United States)

    Treloar, Carla; McCredie, Luke; Lloyd, Andrew R

    2016-01-01

    A formal Needle and Syringe Program (NSP) is not provided in Australian prisons. Injecting equipment circulates in prisons as part of an informal and illegal economy. This paper examined how this economy generates blood-borne virus (BBV) risk and risk mitigation opportunities for inmates. The HITS-p cohort recruited New South Wales inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. For this study, qualitative interviews were conducted with 30 participants enrolled in HITS-p. Participants included 10 women and were incarcerated in 12 prisons. A needle/syringe was nominated as being typically priced in the 'inside' prison economy at $100-$150, with a range of $50-$350. Purchase or hire of equipment was paid for in cash (including transactions that occurred outside prison) and in exchange for drugs and other commodities. A range of other resources was required to enable successful needle/syringe economies, especially relationships with visitors and other prisoners, and violence to ensure payment of debts. Strategies to mitigate BBV risk included retaining one needle/syringe for personal use while hiring out others, keeping drug use (and ownership of equipment) "quiet", stealing used equipment from the prison health clinic, and manufacture of syringes from other items available in the prison. The provision of prison NSP would disrupt the inside economies built around contraband needles/syringes, as well as minimise BBV risk. However, any model of prison NSP should be interrogated for any unanticipated markets that could be generated as a result of its regulatory practices.

  10. 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.

  11. Future Challenges and Opportunities in Online Prescription Drug Promotion Research Comment on "Trouble Spots in Online Direct-to-Consumer Prescription Drug Promotion: A Content Analysis of FDA Warning Letters".

    Science.gov (United States)

    Southwell, Brian G; Rupert, Douglas J

    2016-01-16

    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. © 2016 by Kerman University of Medical Sciences.

  12. Drugs prescription pattern in dogs diagnosed with parvovirus ...

    African Journals Online (AJOL)

    Canine parvovirus enteritis affects predominantly puppies with a high prevalence rate in Nigeria and is characterized by diarrhea, vomiting, anorexia and leucopenia. Treatment is non-specific; hence array of medications are usually prescribed to manage the condition symptomatically. Irrational drugs prescription has been ...

  13. Role of the Sales Manager and it's Intersection with Sales Technology

    OpenAIRE

    Kennelly, Stephen

    2008-01-01

    The area of sales management and technology is an expanding and dynamic field of research. Examining the impact and facets of technology in the arena of sales management has been steadily increasing over the past few decades as sales managers and industry seek to benefit from the multiple uses of technology. Large scale quantitative sales research itself in Ireland has been limited over the past 15 years and not since De Burca and Lambkin (1991) performed an analysis of the industry has there...

  14. [Safe injection rooms and police crackdowns in areas with heavy drug dealing. Evaluation by counting discarded syringes collected from the public space].

    Science.gov (United States)

    Vecino, Carmen; Villalbí, Joan R; Guitart, Anna; Espelt, Albert; Bartroli, Montserrat; Castellano, Yolanda; Brugal, M Teresa

    2013-01-01

    The evolution of drug injection in public places is analysed using as indicator the number of syringes collected from public spaces, evaluating as well the influence of public health harm reduction interventions and of police actions, with a before and after quasi experimental study. Monthly syringe counts on the semester before and after each intervention were compared both in the involved district and in the city as a whole, using the U and z tests with a 95% confidence level. The average number of collected syringes drops from 13.132 in 2004 to 3.190 in 2012. Comparing indicators before and after health and police interventions, the opening of a facility with a supervised drug consumption room in the inner city was associated with a huge reduction in the number of abandoned syringes in the city, while its number did not rise in the district where the facility was located. The subsequent opening of another drug consumption room did not have a significant impact in collected syringes in the area. Some police interventions in 2005-2006 and 2011 had a significant impact in the indicators of the involved districts, while others did not. Harm reduction programs might have a favourable impact on drug injection in public spaces and related syringe presence. Some police interventions appear to have an impact while others do not or just have a modest local and temporary effect.

  15. 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

  16. 76 FR 174 - International Business Machines (IBM), Global Sales Operations Organization, Sales and...

    Science.gov (United States)

    2011-01-03

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,575; TA-W-74,575D] International Business Machines (IBM), Global Sales Operations Organization, Sales and Distribution Business Manager Roles; One Teleworker Located in Charleston, WV; International Business Machines (IBM), Global Sales Operations Organization, Sales and...

  17. Single patient doses of {sup 99m}Tc-HDP: Assessment of radiochemical purity, sterility and extractables from a polypropylene syringe over six hours

    Energy Technology Data Exchange (ETDEWEB)

    Parkes, S.L.; Varelis, P. [St George Hospital, Kogarah, NSW (Australia). Department of Nuclear Medicine

    1997-12-01

    Full text: The purpose of this investigation was to determine the radiochemical purity (RCP), sterility and extractables for {sup 99m}Tc oxidronate ({sup 99m}Tc-HDP) stored in polypropylene syringes over < six-hour period. The radiochemical purity was determined using a two-strip ITLC procedure, performed at time 0, 1, 2, 4, 6 hours. The sterility and endotoxin levels were tested by a NATA accredited laboratory, after allowing the radiopharmaceutical to stand at room temperature for six hours in the syringes. Plasticisers and other likely compounds that could be extracted from the syringes into the aqueous solution were determined by high pressure liquid chromatography (HPLC) diode array detection. This analysis involved shaking normal saline in a syringe over night and then injecting an aliquot of this solution onto a C18 analytical column and monitoring the effluent at 200 and 253 nm. The radiochemical purity of {sup 99m}Tc-HDP did not significantly change over the course of the study and remained above the recommended RCP for this radiopharmaceutical. Furthermore, at six hours the RCP of {sup 99m}Tc-HDP stored in both the manufacturer`s vial and a syringe were identical. Sterility testing of {sup 99m}Tc-HDP stored in syringes showed no microbial growth and less than 10 endotoxin units/mL (pass). The HPLC analysis did not show the presence of any extraneous compounds in the aqueous solution. Single patient doses of {sup 99m}Tc-HDP stored in polypropylene syringes over a six-hour period fulfill all the quality control requirements for administration to humans.

  18. 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.

  19. [2000-year history of the ear syringe and its relationship to the enema. Images from the history of otorhinolaryngology, represented by instruments from the collection of the Ingolstadt Medical History Museum].

    Science.gov (United States)

    Feldmann, H

    1999-08-01

    SYRINGES WITH A PISTON AND THEIR USE AS "CLYSTER ORICULARIUS" IN THE ANCIENT ROME: Syringes with a piston were already known in ancient times and have been mentioned as a device for spraying rose water (Philon of Byzantium, about 230 BC), and for fighting fires (Heron of Alexandria about 110 AD). Celsus mentions it several times in his grand opus "De Medicina" (1st century AD) in the treatment of purulent discharge from the ear and for removing foreign bodies from the external ear canal. He always calls it "clyster oricularius", i.e. ear syringe, even when he describes its use in applications other than otological, such as in urology. Later the ear syringe fell from favor for a very long time and was reinvented only at the beginning of the 19th century. IRRIGATION OF THE BOWELS, FROM THE BAG SYRINGE TO THE PISTON SYRINGE: Irrigations of the bowels, clysters, were performed from ancient times to the 18th century with a baglike syringe using the bladder of animals as a pouch. Syringes with a piston were used by barbers and surgeons only for cleansing wounds or irrigating natural cavities of the body. Irrigation of the external ear canal had completely fallen from favor. In France in the 18th century large syringes with a piston made of tin oder brass came into use for enemas and replaced the old baglike devices. THE REINVENTION OF THE EAR SYRINGE AFTER THE PROTOTYPE OF THE ENEMA SYRINGE: Itard, an otologist in France in 1821, was the first to describe irrigating the ear with a syringe to remove hard wax. He recommended using an enema syringe ("seringue à lavement") for the procedure. Soon after his publication special ear syringes of appropriate size were developed and described by Beck in Freiburg, Germany, in 1827; by Fabrizi in Modena, Italy, 1839; and Schmalz in Dresden, Germany, 1846, who also introduced the kidney-shaped bowel for catching the water. Apart from that, small baglike syringes made of rubber were devised especially for use by the patient himself

  20. Kidney sales and the analogy with dangerous employment.

    Science.gov (United States)

    Malmqvist, Erik

    2015-06-01

    Proponents of permitting living kidney sales often argue as follows. Many jobs involve significant risks; people are and should be free to take these risks in exchange for money; the risks involved in giving up a kidney are no greater than the risks involved in acceptable hazardous jobs; so people should be free to give up a kidney for money, too. This paper examines this frequently invoked but rarely analysed analogy. Two objections are raised. First, it is far from clear that kidney sales and dangerous jobs involve comparable risks on an appropriately broad comparison. Second, and more importantly, even if they do involve comparable risks it does not follow that kidney sales must be permitted because dangerous jobs are. The analogy assumes that kidney sales are banned for paternalistic reasons. But there may be other, non-paternalistic reasons for the ban. And paternalists, too, can consistently defend the ban even if kidney sales are no riskier than occupations that they find acceptable. Soft paternalists may want to protect would-be vendors from harms that they have not voluntarily chosen. Egalitarian hard paternalists may want to protect already badly off vendors from further worsening their situation. For neither species of paternalist is the size of the risk prevented decisive. I conclude that the analogy with dangerous jobs, while rhetorically powerful, pulls little real argumentative weight. Future debates on living kidney sales should therefore proceed without it.

  1. 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

  2. [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

  3. 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.

  4. Are major reductions in new HIV infections possible with people who inject drugs? The case for low dead-space syringes in highly affected countries.

    Science.gov (United States)

    Zule, William A; Cross, Harry E; Stover, John; Pretorius, Carel

    2013-01-01

    Circumstantial evidence from laboratory studies, mathematical models, ecological studies and bio behavioural surveys, suggests that injection-related HIV epidemics may be averted or reversed if people who inject drugs (PWID) switch from using high dead-space to using low dead-space syringes. In laboratory experiments that simulated the injection process and rinsing with water, low dead space syringes retained 1000 times less blood than high dead space syringes. In mathematical models, switching PWID from high dead space to low dead space syringes prevents or reverses injection-related HIV epidemics. No one knows if such an intervention is feasible or what effect it would have on HIV transmission among PWID. Feasibility studies and randomized controlled trials (RCTs) will be needed to answer these questions definitively, but these studies will be very expensive and take years to complete. Rather than waiting for them to be completed, we argue for an approach similar to that used with needle and syringe programs (NSP), which were promoted and implemented before being tested more rigorously. Before implementation, rapid assessments that involve PWID will need to be conducted to ensure buy-in from PWID and other local stakeholders. This commentary summarizes the existing evidence regarding the protective effects of low dead space syringes and estimates potential impacts on HIV transmission; it describes potential barriers to transitioning PWID from high dead space to low dead space needles and syringes; and it presents strategies for overcoming these barriers. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. 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.

  6. Point-of-Purchase Labels and Reward Cards Improve Sales of Healthy Foods in University Dining Halls.

    Science.gov (United States)

    Biden, Catherine R; Matthews, June I; Laframboise, Natalie A; Zok, Anne; Dworatzek, Paula D N; Seabrook, Jamie A

    2018-06-12

    To compare sales of Food Resources and Education for Student Health (FRESH) Approved versus non-FRESH Approved menu cycle items pre- and postimplementation of the FRESH program. Sales data from 2011-2015 of FRESH Approved versus non-FRESH Approved menu items were analyzed. Fruit and milk items sold, net sales, and the cost of free fruit and milk redeemed through the FRESH Reward Card (FRC) program, were also analyzed. FRESH Approved items sold more often than non-FRESH Approved items in the latter 2 years (P = 0.01). Prices of FRESH Approved menu items were significantly lower than non-FRESH Approved items for all years (e.g., $1.52 ± $0.94 vs $2.21 ± $1.02 per serving in 2014-2015; P < 0.001). Across all FRESH implementation years, FRESH Approved menu items were found more often on the 6-week menu (P < 0.05). The number of fruit items sold increased from a baseline of 143 052 to 170 954, and net sales increased from $135 450 to $154 248 after 3 years of the FRC implementation. FRESH Approved items were less expensive, available more often, and had higher sales. The FRC increased net fruit sales despite the cost of free fruit. Highlighting and reducing the cost of healthy foods are promising practices to improve campus food environments.

  7. Analysis performed in cooperation with the SALE program, (1)

    International Nuclear Information System (INIS)

    Tuboya, Takao; Wada, Yukio; Suzuki, Takeshi

    1978-01-01

    One of the objects of the SALE (Safeguard Analytical Laboratory Evaluation) program is a development of technique in safeguard and accountability. The SALE program was established by the United States Atomic Energy Commission's New Brunswick Laboratory in 1970. Six years later, SALE program has grown into a worldwide quality control program, receiving analysis results from about 60 laboratories that includes 19 non-U.S. laboratories. All laboratories, participating at present or in the past in the SALE program are listed in Table 1. By 1973, the program was expanded to include six different materials; uranium dioxide (UO 2 ), uranyl nitrate (U-NO 3 ), plutonium dioxide (PuO 2 ), plutonium nitrate (Pu-NO 3 ), uranium-plutonium mixed oxides [(Pu,U)O 2 ], and uranium-plutonium mixed nitrates (Pu-U-NO 3 ). PNC has joined in this program in 1975 for the analysis of samples shown in Table 2. SALE program participants analyze, on a bimonthly basis, materials supplied by the New Brunswick Laboratory (NBL) and report measurement results to NBL for evaluation and inclusion in the bimonthly reports. Present paper describes analysis result and evaluations for these samples which were measured in 1975 -- 1976. (author)

  8. 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.

  9. A Pluralist Approach to the Law of International Sales

    Directory of Open Access Journals (Sweden)

    Juana Coetzee

    2017-03-01

    Full Text Available International trade can support economic development and social upliftment. However, people are often discouraged from contracting internationally due to the existence of differences in legal systems which act as a non-tariff barrier to trade. This article focuses on the private law framework regulating international contracts of sale. During the twentieth century the problem of diverse laws was primarily addressed by global uniform law such as the United Nations Convention on Contracts for the International Sale of Goods (CISG. However, uniform law is rarely complete and has to be supplemented by national law, trade usage or party agreement. Because there are gaps in the CISG the Swiss government has made a proposal for a new global contract law. But is this a feasible solution to the fragmentary state of international trade law? In Europe, signs of resistance are setting in against further harmonisation. The Proposal for a Common European Sales Law (CESL was recently withdrawn, and now Britain has voted to leave the European Union. Rumour has it that more countries might follow. The current private law framework for international sales contracts consists of a hybrid system where international, national, state and non-state law function side by side. This article submits that universalism is not per se the most efficient approach to the regulation of international sales law and that economic forces require a more varied approach for business-to-business transactions. The biggest challenge, however, would be to manage global legal pluralism. It is concluded that contractual parties, the courts and arbitral tribunals can effectively manage pluralism on a case-by-case basis.

  10. Behavioural aspects surrounding medicine purchases from pharmacies in Australia

    Directory of Open Access Journals (Sweden)

    Emmerton L

    2008-09-01

    Full Text Available Objective: This study aimed to produce current data regarding behavioural aspects of non-prescription (over-the-counter medicine purchases, in light of changes in the pharmaceutical market and increasing provision of professional services in pharmacies.Methods: Data were collected in 15 community pharmacies in South-East Queensland, Australia, over 540 hours in five days in August, 2006. The method, previously validated, involved documentation of both observational and interview data. Fifteen trained researchers were stationed in a selected pharmacy each to unobtrusively observe all eligible sales of non-prescription medicines, and, where possible, interview the purchasers post-sale. Non-response was supplemented by observational data and recall by the salesperson. The data included details of the purchase and purchasing behaviour, while new questions addressed issues of topical importance, including customers’ privacy concerns. A selection of the analyses is reported here.Results: In total, 3470 purchases were documented (135-479 per pharmacy, with customers of 67.5% of purchases (74.7% excluding an outlier pharmacy participating in the survey. Customers averaged 1.2 non-prescription medicines per transaction. Two-thirds (67.2% of customers were female, and 38.8% of the customers were aged 31-45 years. Analgesics and respiratory medicines accounted for two-thirds of the sales data (33.4% and 32.4%, respectively. Intended-brand purchases comprised 71% of purchases (2004/2824; in-store substitution then occurred in 8.8% of these cases, mainly following recommendations by pharmacy staff. Medicines intended for self-use comprised 62.9% of purchases (1752/2785. First-time purchases (30.8%, 799/2594 were more commonly influenced by pharmacy staff than by advertising.Conclusions: This study used validated methods adapted to a changing marketplace, thus providing data that both confirm and add to knowledge surrounding medicine purchases. Despite the

  11. The Association Between Law Enforcement Encounters and Syringe Sharing Among IDUs on Skid Row: A Mixed Methods Analysis

    Science.gov (United States)

    Simon-Freeman, Rebecca; Bluthenthal, Ricky N.

    2013-01-01

    The legal environment is one factor that influences injection drug users' (IDUs) risk for HIV and other bloodborne pathogens such as hepatitis C virus (HCV). We examined the association between law enforcement encounters (i.e., arrests and citations) and receptive syringe sharing among IDUs in the context of an intensified policing effort. We conducted a mixed methods analysis of 30 qualitative and 187 quantitative interviews with IDUs accessing services at a Los Angeles, CA syringe exchange program from 2008 to 2009. Qualitative findings illustrate concerns related to visibility, drug withdrawal, and previous history of arrest/incarceration. In quantitative analysis, the number of citations received, current homelessness, and perceiving that being arrested would be a “big problem” were independently associated with recent syringe sharing. Findings illustrate some of the unintended public health consequences associated with intensified street-level policing, including risk for HIV and HCV transmission. PMID:23620243

  12. 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

  13. Federal funding for syringe exchange in the US: Explaining a long-term policy failure.

    Science.gov (United States)

    Showalter, David

    2018-05-01

    The United States prohibited federal funding for syringe exchange programs for people who inject drugs nearly continuously from 1988 to 2015, despite growing scientific evidence, diminishing AIDS-related controversy, and tens of thousands of deaths from injection-related AIDS. This study investigates the political and institutional bases of this long-term failure to support lifesaving public policy. This study draws on national, regional, and local media coverage, archival sources, and semi-structured, in-depth interviews with 6 long-time syringe exchange researchers and activists from California. I use case-oriented process tracing methods to explain the persistence and reform of the federal funding ban. Though previous studies focus on the symbolic clash between conservative morality and empirical science, I find that changing demographic and regional inequalities in the effects of the AIDS epidemic and dynamics produced by the federal structure of US government were more important factors in the creation and persistence of the funding ban. The persistence and eventual repeal of the ban on federal funding for syringe exchange was a product of the changing demographic, geographic, and political effects of the AIDS epidemic within the federal structure of US government, rather than a consequence of intractable morality politics. These contextual dynamics continue to shape AIDS and public health policy at all levels of government. Copyright © 2018. Published by Elsevier B.V.

  14. [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.

  15. SALES DOCUMENTS IN PURCHASE AND SALE TRANSACTIONS OF STEAM COAL IN POLAND

    OpenAIRE

    Anna Galik

    2015-01-01

    This article describes sales documents in purchase and sale transactions of steam coal in Poland. In relation to introducing the excise tax on steam coal at the beginning in 2012, additional requirements appeared in documents during the sale of goods. Now the seller is obliged to issue various documents depending on the type of the buyer and the destination of goods. The article presents the coal sales documents for households, companies with no tax payment and companies with tax payment. The...

  16. Optimizing Effectiveness in Electronic Prescriptions for Pediatric Outpatients: A Call for Responsive Action

    Directory of Open Access Journals (Sweden)

    Richard H. Parrish II

    2014-09-01

    Full Text Available A pediatric compounded non-sterile products repository (pCNP to optimize the effectiveness and safety of “off-label” use of compounded pharmacotherapy through complete transmission of electronic prescriptions across the continuum of care is described. The advent of electronic prescribing has the potential to refocus and resolve long-standing issues of prescription therapy for pediatric patients related to formulation, indication, dosing, and outcomes follow-up, among others. This white paper describes the architecture and function of the pCNP repository. Further, it calls on professional societies, health information technology (HIT and pharmaceutical industries, universities, and government to create a safer pediatric pharmacotherapy system across the continuum of care. This system would include pCNPs within the existing federal and corporate database structures for medical language, and integrates advanced system safety features as requirements for prescribing, compounding, and dispensing non-mass produced prescription therapies for children.

  17. 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.

  18. Sales Role-Plays and Mock Interviews: An Investigation of Student Performance in Sales Competitions

    Science.gov (United States)

    Mani, Sudha; Kothandaraman, Prabakar; Kashyap, Rajiv; Ashnai, Bahar

    2016-01-01

    Sales competitions provide students with opportunities to apply their understanding of sales. Despite a long tradition of scholarship on sales role-plays, the answer to what drives student performance in sales competitions remains elusive. In this research, we examine how motivation (work engagement) and ability (cognitive aptitude and…

  19. 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.

  20. The anxieties of globalization: antidepressant sales and economic crisis in Argentina.

    Science.gov (United States)

    Lakoff, Andrew

    2004-04-01

    This paper describes the role of market research firms in shaping the actions of key players in the pharmaceutical arena. It focuses on strategies for marketing novel antidepressants (selective serotonin reuptake inhibitors, SSRIs) to doctors in Buenos Aires during the Argentine financial crisis of 2001, posing the question of whether increased antidepressant sales were due to the social situation or to promotional practices. This case demonstrates how 'pharmaceutical relations' - interactions between doctors and pharmaceutical companies - are structured by a gift economy whose effects are monitored through the sales numbers produced by database firms. It suggests that the use of these numbers takes on special importance given the distinctiveness of both the Argentine context and the antidepressant market. More generally, the case points to the interpretive flexibility of psychotropic medication. In the Argentine setting, doctors' prescription of SSRIs was dependent neither on a diagnosis of depression nor on a biological understanding of mental disorder. These drugs found a different means of entering the professionally mediated marketplace: doctors understood and used SSRIs as a treatment not for a lack of serotonin in the brain, but for the suffering caused by the social situation - the sense of insecurity and vulnerability that the economic and political crisis had wrought.

  1. Better sales networks.

    Science.gov (United States)

    Ustüner, Tuba; Godes, David

    2006-01-01

    Anyone in sales will tell you that social networks are critical. The more contacts you have, the more leads you'll generate, and, ultimately, the more sales you'll make. But that's a vast oversimplification. Different configurations of networks produce different results, and the salesperson who develops a nuanced understanding of social networks will outshine competitors. The salesperson's job changes over the course of the selling process. Different abilities are required in each stage of the sale: identifying prospects, gaining buy-in from potential customers, creating solutions, and closing the deal. Success in the first stage, for instance, depends on the salesperson acquiring precise and timely information about opportunities from contacts in the marketplace. Closing the deal requires the salesperson to mobilize contacts from prior sales to act as references. Managers often view sales networks only in terms of direct contacts. But someone who knows lots of people doesn't necessarily have an effective network because networks often pay off most handsomely through indirect contacts. Moreover, the density of the connections in a network is important. Do a salesperson's contacts know all the same people, or are their associates widely dispersed? Sparse networks are better, for example, at generating unique information. Managers can use three levers--sales force structure, compensation, and skills development--to encourage salespeople to adopt a network-based view and make the best possible use of social webs. For example, the sales force can be restructured to decouple lead generation from other tasks because some people are very good at building diverse ties but not so good at maintaining other kinds of networks. Companies that take steps of this kind to help their sales teams build better networks will reap tremendous advantages.

  2. A clinical comparative study between conventional and camouflaged syringes to evaluate behavior and anxiety in 6-11-year-old children during local anesthesia administration-a novel approach.

    Science.gov (United States)

    Melwani, Anjana M; Srinivasan, Ila; Setty, Jyothsna V; D R, Murali Krishna; Pamnani, Sunaina S; Lalitya, Dandamudi

    2018-02-01

    The sight of dental injection can bring about severe anxiety in children. Therefore, an alternative method that is convenient, effective, and keeps the needle hidden making it child friendly is necessary. The objective of the study was to compare the efficacy of a camouflaged syringe and conventional syringe on behavior and anxiety in 6-11-year-old children during local anesthesia administration. The study was a randomized, crossover clinical study including 30 children. Children were separated into two groups. Group 1 consisted of 15 children aged 6-8 years while group 2 consisted of 15 children aged 9-11 years. This study involved two sessions wherein all the children were injected using conventional and camouflaged syringes in separate sessions. Their behavior was assessed using the Faces, Legs, Activity, Cry, Consolability (FLACC) behavior pain scale and anxiety was assessed by measuring changes in pulse rate. Patient and operator preferences were compared. The results showed a lower mean change in pulse rate and FLACC scores in the camouflaged group, suggesting a positive behavior and lesser anxiety with camouflaged syringes than with conventional syringes. The use of camouflaged syringes for anesthesia was demonstrated to be effective in improving the behavior of children and decreasing their anxiety, and is therefore recommended as an alternative to the use of conventional syringes for local anesthesia.

  3. Internet cigarette sales and Native American sovereignty: political and public health contexts.

    Science.gov (United States)

    Samuel, Kari A; Ribisl, Kurt M; Williams, Rebecca S

    2012-05-01

    Internet cigarette vendors (ICVs) advertise low prices for tobacco products, subverting public health policy efforts to curtail smoking by raising prices. Many online retailers in the United States claim affiliation with Native American tribes and share in tribal tax-free status. Sales of discounted cigarettes from both online vendors and brick-and-mortar stores have angered non-Native retailers and triggered enforcement actions by state and federal governments in the United States concerned over lost cigarette excise tax revenue. Examination of the history and politics of cigarette sales on reservations and attempts to regulate Internet cigarette sales highlights the potential role for greater use of negotiated intergovernmental agreements to address reservation-based tobacco sales. Our review notes global parallels and explicates history and politics of such regulation in the United States, and offers background for collaborative efforts to regulate tobacco sales and decrease tobacco use.

  4. Prescription pattern of antibiotic and analgesic in endodontic treatment in Kuwaiti population: A self-administered Survey

    Directory of Open Access Journals (Sweden)

    Manal J Al-Maslamani

    2014-01-01

    Full Text Available Introduction: Surgical and non-surgical endodontic treatment of involved teeth can necessitate prescription of analgesics and antimicrobials. The literature suggests confusion amongst practitioners regarding the need for adjunctive medication, mainly during non-surgical endodontic treatment, often leading to over-prescription. Aim: The aim of this study was to determine the current clinical practice of dentists participated in this study with respect to antibiotic and analgesic prescription patterns in their endodontic treatment management in Kuwait. Materials and Methods: Prescription patterns for antibiotics and analgesics were analyzed based on the responses to self-administered questionnaire (n = 169. Information was collected based on different clinical endodontic diagnostic scenarios. Statistical analysis was performed with SPSS software version 17.0 to determine relationships between prescription patterns, age, gender, and dental qualification (specialists and general dentists. Results: Ninety-two percent of dentists prescribed analgesics for the management of endodontic pain. While 16% prescribed antibiotics for severe dental pain; 62% prescribed antibiotics for acute apical abscesses. Significantly more male dentists prescribed antibiotics for dental pain than female dentists. No significant difference was found between general dental practitioners′ and specialists′ attitude toward drug prescriptions. Amoxicillin and ibuprofen were the most commonly prescribed medications. Conclusion: While the majority of dentists appeared to prescribe antibiotics and analgesics appropriately, some did not. This research confirmed previous studies and established a need for imparting information of evidence-based prescriptions protocols for the dentists surveyed in this study in Kuwait.

  5. Selling Sales: Factors Influencing Undergraduate Business Students' Decision to Pursue Sales Education

    Science.gov (United States)

    Allen, Concha; Kumar, Poonam; Tarasi, Crina; Wilson, Holt

    2014-01-01

    With a better understanding of the typical sales student, sales educators can design and deliver curriculum with a more customer-oriented approach. In order to better understand the decision to pursue sales education, more than 500 undergraduate business students at a large Midwestern university participated in a survey that examined the factors…

  6. Influence of change in sales networks on a firm’s sales strategy

    OpenAIRE

    Sandau, A. (Alexander)

    2014-01-01

    Abstract This research revolves around two major theoretical topics: international network and international sales. The study aims to combine both distinct research areas in order to understand how changes in the sales network influence the sales strategy of the firm. The focus is hereby on born global companies respectively international new ventures. ...

  7. Prescription of Non-Occupational Post-Exposure HIV Prophylaxis by Emergency Physicians: An Analysis on Accuracy of Prescription and Compliance.

    Directory of Open Access Journals (Sweden)

    Stefano Malinverni

    Full Text Available We conducted a retrospective analysis of data from a prospective nPEP (non-Occupational Post Exposure Prophylaxis registry based on patients consulting at one academic Emergency department located in Brussels, Belgium. We review here 1,357 cases consulting from January 2011 to December 2013.The objective of the study is to determine whether emergency physicians prescribe nPEP according to national guideline with support from IDS (infectious disease specialists. As this intervention has a high cost we wanted to verify correct allocation of treatment to high risk patients. Moreover we wanted to determine whether compliance to nPEP when prescribed by an Emergency Physician was different from literature reports. Finally we wanted to describe the population consulting for nPEP at our center. Emergency physicians prescribed nPEP more frequently in high risk exposures (98.6% compared to intermediate risk exposures (53.2%; adequately allocating resources from a public health perspective. Appropriateness of prescription when evaluated according to nPEP Belgian guidelines was 98.8%.Compliance with nPEP prescribed by Emergency physicians was 60% in our study. Compliance was the highest in MSM (Men who have Sex with Men while sexual assault victims showed the lowest compliance. Altogether this study suggests that Emergency physicians can safely and adequately prescribe nPEP when supported by a comprehensive guideline. Recognizing intrinsic differences within heterogeneous populations consulting for nPEP may improve compliance to this high-cost public health intervention.

  8. BUILDING AN EFFECTIVE SALES FORCE

    Directory of Open Access Journals (Sweden)

    Ioana Olariu

    2016-06-01

    Full Text Available Building an effective sales force starts with selecting good salespeople, but good salespeople are very difficult to find. The reason for this is that most sales jobs are very demanding and require a great deal from the salesperson. There are many different types of sales jobs. Before it can hire salespeople, each company must do a careful job analysis to see what particular types of selling and other skills are necessary for each sales job. One task of the market planner is to establish clear objectives each year for the entire sales force, for each region, each sales office, and each salesperson. Sales jobs are different from in-house jobs in some significant ways. Nevertheless, each company must continually work on building and maintaining an effective sales force using the following steps: recruitment, selection, training, compensation and evaluation of each salesperson.

  9. 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)

  10. SALES DOCUMENTS IN PURCHASE AND SALE TRANSACTIONS OF STEAM COAL IN POLAND

    Directory of Open Access Journals (Sweden)

    Anna Galik

    2015-06-01

    Full Text Available This article describes sales documents in purchase and sale transactions of steam coal in Poland. In relation to introducing the excise tax on steam coal at the beginning in 2012, additional requirements appeared in documents during the sale of goods. Now the seller is obliged to issue various documents depending on the type of the buyer and the destination of goods. The article presents the coal sales documents for households, companies with no tax payment and companies with tax payment. The purpose of this article is to present complicated and time-consuming procedures during the sale of goods, as a result of the current excise tax on steam coal. In conclusion the author identify new solutions that are beneficial for the seller and the buyer.

  11. 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...

  12. Correlates of lending needles/syringes among HIV-seropositive injection drug users.

    Science.gov (United States)

    Metsch, Lisa R; Pereyra, Margaret; Purcell, David W; Latkin, Carl A; Malow, Robert; Gómez, Cynthia A; Latka, Mary H

    2007-11-01

    Among HIV-positive injection drug users (IDUs), we examined the correlates of lending needles/syringes with HIV-negative and unknown status injection partners. HIV-positive IDUs (N=738) from 4 cities in the United States who reported injection drug use with other IDUs in the past 3 months participated in an audio computer-assisted self-administered interview. Eighteen percent of study participants self-reported having lent their needles to HIV-negative or unknown status injection partners. Multivariate analyses showed that 6 variables were significantly associated with this high-risk injecting practice. Older IDUs, high school graduates, and those reporting more supportive peer norms for safer drug use were less likely to lend needles/syringes. Admission to a hospital for drug treatment in the past 6 months, having injected with >1 person in the past 3 months, and having more psychiatric symptoms were all associated with more risk. These findings underscore the need for a continued prevention focus on HIV-positive IDUs that recognizes the combination of drug use, mental health factors, and social factors that might affect this high-risk injecting practice, which could be associated with HIV and hepatitis C transmission.

  13. 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.

  14. Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications.

    Science.gov (United States)

    Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A; Ovejero-García, Santiago; Álvarez-García, Raquel; Carballo, Juan Jose; Lenca, Philippe; Courtet, Philippe; Baca-García, Enrique

    2016-01-01

    The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system.

  15. An Analysis of Lost Sales

    Directory of Open Access Journals (Sweden)

    Jeffrey E. Jarrett

    2015-08-01

    Full Text Available The purpose of this manuscript is to shed light on problems associated with lost sales and the incurring of cost associated with lost sales. An investigation is made to determine if seasonality in sales and lost sales have effects on the efficient operations of supply chains. Optimization is always a goal of management supply chains, but cost increases due to insufficient inventory, low-quality product and the like lead to customers not returning. These are lost sales that occur for many reasons. We study a data set to determine if the ignoring of time series component also has an effect on the variation in lost sales. If so, can we measure the magnitude of the effects of seasonal variation in lost sales, and what are their consequences?

  16. Fire Sales and House Prices

    DEFF Research Database (Denmark)

    Andersen, Steffen; Meisner Nielsen, Kasper

    2017-01-01

    This study investigates when forced sales of real estate turn into fire sales by using a natural experiment that allows us to separate supply and demand effects: Forced sales result from sudden death of house owners and are thus unrelated to current market conditions. We find that forced sales...

  17. Nurses' reported influence on the prescription and use of medication.

    Science.gov (United States)

    Jutel, A; Menkes, D B

    2010-03-01

    To identify the activities senior nurses report undertaking that may influence the prescription and use of medicines. While much attention has focused on the role of nurse prescribing, little is known about the extent to which non-prescribing nurses influence medication decision making. The pharmaceutical industry recognizes this influence in its marketing strategies, and courts nurses by provision of promotional material and sponsorship of nursing professional development. We undertook parallel web- and paper-based surveys of 100 senior registered nurses employed by government-funded health boards in two distinct New Zealand regions. Only 2/96 (2%) of nurses had prescribing rights, yet 74/94 (79%) reported recommending treatments to the prescribing doctor, 74/95 (79%) stated they provided advice to patients about over-the-counter medications and 71/92 (77%) participated in the development of guidelines or policies that include the use of medications. All nurses in this sample reported influencing the prescription of medicines in one way or another. From actually writing prescriptions to providing feedback on treatment outcomes, there are many opportunities for nurses to influence the decision making of medical and other prescribers, which open nurses to exploitation from commercial forces. Policy and education regarding prescriber relationships with the pharmaceutical industry should also recognize the role of non-prescribing nurses.

  18. A Sales Representative Is Made: An Innovative Sales Course

    Science.gov (United States)

    Levin, Michael A.; Peterson, Lori T.

    2016-01-01

    Job openings for nonscientific business-to-business sales professionals will increase over the next 10 years. A small private university in the Midwest has developed an innovative sales course to help create professionals who are ready to fill this need. This article addresses the challenges of creating a meaningful, hands-on, experiential course…

  19. Timing of Seasonal Sales.

    OpenAIRE

    Courty, Pascal; Li, Hao

    1999-01-01

    We present a model of timing of seasonal sales where stores choose several designs at the beginning of the season without knowing wich one, if any, will be fashionable. Fashionable designs have a chance to fetch high prices in fashion markets while non-fashionable ones must be sold in a discount market. In the beginning of the season, stores charge high prices in the hope of capturing their fashion market. As the end of the season approaches with goods still on the shelves, stores adjust down...

  20. Editorial: Sales Strategy (2010)

    OpenAIRE

    Chris McPhee

    2010-01-01

    The editorial theme for this issue of the OSBR is Sales Strategy. While "marketing" is everything a company does to build interest in its offers, "sales" consists of converting these offers into cash. By "sales strategy," we refer to all sales planning and process development activities leading up to the actual selling of a product or service. In his recent blog post at MaRS Discovery District, Mark Zimmerman answered a question he is frequently asked by the founders of startups: "How do we f...

  1. [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.

  2. Stability of busulfan solutions in polypropylene syringes and infusion bags as determined with an original assay.

    Science.gov (United States)

    Guichard, Nicolas; Bonnabry, Pascal; Rudaz, Serge; Fleury-Souverain, Sandrine

    2017-11-15

    The stability of busulfan solution in 0.9% sodium chloride and stored in polypropylene syringes or infusion bags was evaluated. Busulfan solutions (0.54 mg/mL) were prepared and transferred to 50-mL polypropylene syringes and 100- and 500-mL polypropylene infusion bags and stored at 2-8 and 23-27 °C. Chemical stability was measured using a stability-indicating, ultrahigh performance liquid chromatography coupled to mass spectrometry method. The stability of busulfan was assessed by measuring the percentage of the initial concentration remaining at the end of each time point of analysis. The initial busulfan concentration was defined as 100%. Stability was defined as retention of at least 90% of the initial busulfan concentration. A visual inspection of the samples for particulate matter, clarity, and color without instrumentation of magnification was conducted at each time point of analysis. The visual inspection demonstrated no influence of the storage container when busulfan infusions diluted in 0.9% sodium chloride injection were stored at 23-27 °C. No color change or precipitate was observed at this temperature; however, a rapid decrease of the busulfan content in all containers stored at room temperature was observed. Busulfan in syringes was chemically stable for 12 hours, while busulfan in infusion bags (100 and 500 mL) was stable only for 3 hours at 23-27 °C. Busulfan 0.54-mg/mL solution in 0.9% sodium chloride injection was physically and chemically stable for 30 hours when stored in 50-mL polypropylene syringes at 2-8 °C and protected from light. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  3. Behavioral response and pain perception to computer controlled local anesthetic delivery system and cartridge syringe

    Directory of Open Access Journals (Sweden)

    T D Yogesh Kumar

    2015-01-01

    Full Text Available Aim: The present study evaluated and compared the pain perception, behavioral response, physiological parameters, and the role of topical anesthetic administration during local anesthetic administration with cartridge syringe and computer controlled local anesthetic delivery system (CCLAD. Design: A randomized controlled crossover study was carried out with 120 children aged 7-11 years. They were randomly divided into Group A: Receiving injection with CCLAD during first visit; Group B: Receiving injection with cartridge syringe during first visit. They were further subdivided into three subgroups based on the topical application used: (a 20% benzocaine; (b pressure with cotton applicator; (c no topical application. Pulse rate and blood pressure were recorded before and during injection procedure. Objective evaluation of disruptive behavior and subjective evaluation of pain were done using face legs activity cry consolability scale and modified facial image scale, respectively. The washout period between the two visits was 1-week. Results: Injections with CCLAD produced significantly lesser pain response, disruptive behavior (P < 0.001, and pulse rate (P < 0.05 when compared to cartridge syringe injections. Application of benzocaine produced lesser pain response and disruptive behavior when compared to the other two subgroups, although the result was not significant. Conclusion: Usage of techniques which enhance behavioral response in children like injections with CCLAD can be considered as a possible step toward achieving a pain-free pediatric dental practice.

  4. Improving Information on Maternal Medication Use by Linking Prescription Data to Congenital Anomaly Registers

    DEFF Research Database (Denmark)

    de Jonge, Linda; Garne, Ester; Gini, Rosa

    2015-01-01

    INTRODUCTION: Research on associations between medication use during pregnancy and congenital anomalies is significative for assessing the safe use of a medicine in pregnancy. Congenital anomaly (CA) registries do not have optimal information on medicine exposure, in contrast to prescription...... databases. Linkage of prescription databases to the CA registries is a potentially effective method of obtaining accurate information on medicine use in pregnancies and the risk of congenital anomalies. METHODS: We linked data from primary care and prescription databases to five European Surveillance...... of Congenital Anomalies (EUROCAT) CA registries. The linkage was evaluated by looking at linkage rate, characteristics of linked and non-linked cases, first trimester exposure rates for six groups of medicines according to the prescription data and information on medication use registered in the CA databases...

  5. 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.

  6. 27 CFR 11.22 - Consignment sales.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Consignment sales. 11.22... OF THE TREASURY LIQUORS CONSIGNMENT SALES Unlawful Sales Arrangements § 11.22 Consignment sales. Consignment sales are arrangements wherein the trade buyer is under no obligation to pay for distilled spirits...

  7. 32 CFR 644.544 - Negotiated sales.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 4 2010-07-01 2010-07-01 true Negotiated sales. 644.544 Section 644.544... ESTATE HANDBOOK Disposal Sale Procedure § 644.544 Negotiated sales. (a) To private parties. Negotiated sales to private parties are not viewed with favor. Generally, such negotiated sales will be approved...

  8. Sale of anti-tuberculosis drugs through private pharmacies: a cross sectional study in Kerala, India.

    Directory of Open Access Journals (Sweden)

    Binoo Divakaran

    2011-03-01

    Full Text Available

    Background: Private health care providers are largely the first point of contact for Tuberculosis (TB patients, who either undergo treatment from private practitioners or buy medicines on their own from private pharmacies. Aims: This study assessed the availability, sale and magnitude of anti-tuberculosis drugs dispensing through private pharmacies.

    Methodology: The present cross sectional study was conducted among private pharmacies located along the national highway from Thalassery to Payyannur in the Kannur district of Kerala, India. A total of 38 private pharmacies located along the national highway were included.

    Results: The duration that anti–TB drugs had been on sale showed that 74.3% of pharmacies had started to sell these drugs only less than ten years ago. The majority (82.9% of the private pharmacies received up to 5 prescriptions for anti-TB drugs weekly. Out of the total of 35 pharmacies selling these drugs, 22 (62.9% reported an increase in their sales. Nearly 82% of those pharmacies that reported an increase in the sale of anti-TB drugs were selling these drugs for less than the past ten years.

    Conclusions: The current study shows that a large number of tuberculosis patients are still approaching private pharmacies for anti-tuberculosis drugs. This tendency has to be completely stopped and needs properly planned strategies to encourage private pharmacies to participate actively in the DOTS (Direct Observation Treatment Short course program of the Government, by providing them attractive alternative incentives

  9. Sales promotions and food consumption.

    Science.gov (United States)

    Hawkes, Corinna

    2009-06-01

    Sales promotions are widely used to market food to adults, children, and youth. Yet, in contrast to advertising, practically no attention has been paid to their impacts on dietary behaviors, or to how they may be used more effectively to promote healthy eating. This review explores the available literature on the subject. The objective is to identify if and what literature exists, examine the nature of this literature, and analyze what can be learned from it about the effects of sales promotions on food consumption. The review finds that while sales promotions lead to significant sales increases over the short-term, this does not necessarily lead to changes in food-consumption patterns. Nevertheless, there is evidence from econometric modeling studies indicating that sales promotions can influence consumption patterns by influencing the purchasing choices of consumers and encouraging them to eat more. These effects depend on the characteristics of the food product, sales promotion, and consumer. The complexity of the effects means that sales promotions aiming to encourage consumption of nutritious foods need to be carefully designed. These conclusions are based on studies that use mainly sales data as a proxy for dietary intake. The nutrition (and economics) research communities should add to this existing body of research to provide evidence on the impact of sales promotions on dietary intake and related behaviors. This would help support the development of a sales promotion environment conducive to healthy eating.

  10. 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

  11. Treatment of herniated lumbar disc by percutaneous laser disc decompression combined with synchronous suction technique through syringe

    Institute of Scientific and Technical Information of China (English)

    Dhir B. Gurung; Gaojian Tao; Hongyi Lin; Yanning Qian; Jian Lin

    2007-01-01

    Objective: To compare the outcomes of percutaneous laser disc decompression (PLDD) and PLDD with synchronous suction through syringe in the patients with herniated lumbar disc (HLD). Methods: Forty-two patients with HLD on MRI and those who did not respond to conservative treatment for 6 weeks were randomly divided into group A and group B. In group A, the patients were treated with PLDD and those in group B with PLDD and synchronous suction through syringe. GaAIAS diode laser at 810 nm was used for the ablation in both groups. The treatment effect was evaluated by modified MacNab's criteria on the 7th, 30th and 90th day. Results: Evaluated by modified MacNab's criteria, the percentages of the excellent and good cases in total patients treated for group B and A were 80.95% and 57.14% on the 7th follow-up day, 85.71% and 66.67% on the 30th follow-up day, and 95.24% and 71.43% on the 90th follow-up day, respectively. Conclusion: Synchronous suction technique through syringe during PLDD improves the overall outcome in the treatment of herniated lumbar disc.

  12. Ayurvedic medicine in Mauritius: Profile of Ayurvedic outlet, use, sale, distribution, regulation and importation.

    Science.gov (United States)

    Elaheebocus, Naailah; Mahomoodally, M Fawzi

    2017-02-02

    Ayurvedic medicine (AM) is a legalised alternative traditional medical system in the multicultural tropical island of Mauritius. A panoply of Ayurvedic specialised shops/centres involved in the provision of Ayurvedic services hereafter termed as 'outlets' operates in different regions of the island and is extensively exploited by a significant number of Mauritians. Nonetheless, there is currently no study geared towards studying the status of AM and profile of Ayurvedic outlets in Mauritius and there is undoubtedly a dearth of standardized regulatory framework governing the practice of AM in Mauritius. The present study attempts to study the profile of Ayurvedic outlets, sale, distribution, regulation and importation of AM in Mauritius. To evaluate the characteristics profile of Ayurvedic shops/clinics/pharmacies/centres, to document common Ayurvedic products used in the treatment and management of diseases, and to analyse existing regulatory control of AM in Mauritius. Ayurvedic outlets were identified using a random approach. Once permission granted, outlets were visited where face-to-face interviews with Ayurvedic practitioners/directors/dispensers were undertaken using a semi-structured questionnaire. The characteristics of the outlets with respect to the type of business registration, procurement and dispensing of products, registration and qualification of personnels employed amongst others were studied. The International Classification of Diseases (ICD) 10 was used to classify common AM dispensed to patients. Additionally, information was sought from local authorities pertaining to existing legislation governing the importation and regulation of AM in Mauritius. A total of 16 Ayurvedic outlets ('pharmacies' (n=3), clinics (n=2), shops (n=5) and centres (n=6)) was surveyed. Six outlets dispensed AM strictly on prescription only after consultation with an onsite full-time employed registered Ayurvedic practitioner. Seven outlets offered AM both on prescription

  13. From manager's emotional intelligence to objective store performance: Through store cohesiveness and sales-directed employee behavior

    NARCIS (Netherlands)

    Wilderom, Celeste P.M.; Hur, YounHee; Wiersma, Uco J.; van den Berg, Peter T.; Lee, Jaehoon

    2015-01-01

    The relationships among manager's emotional intelligence, store cohesiveness, sales-directed employee behavior, and objective store performance were investigated. Non-managerial sales employees of a large retail electronics chain in South Korea (N = 1611) rated the emotional intelligence of their

  14. Sales Training for Army Recruiter Success: Modeling the Sales Strategies and Skills of Excellent Recruiters

    Science.gov (United States)

    1987-11-01

    strategies used by excellent Army recruiters. Neurolinguistic programming (NLP) was used as the protocol for modeling performance and acquiring...Behavioral and Social Sciences 3001 Eisenhower Avenue, Alexandria, VA 22333-5600 10. PROGRAM ELEMENT. PROJECT. TASK ARE* 4 WORK UNIT...Modeling ’Expert knowledge,, Neurolinguistics Knowledge engineering; Recruiting Sales, &’ Sales cycle Sales skills Sales strategies 20

  15. AORN sales professional course.

    Science.gov (United States)

    Moss, R; Thompson, J

    1996-04-01

    The sales professional course "Introduction to the Operating Room" offered by the AORN Center for Nursing Practice, Health Policy, and Research is an introductory program in OR etiquette. Its purpose is to provide sales professionals a working knowledge of OR protocol for them to function appropriately in OR settings. Sales professionals who have completed this course establish mutually beneficial perioperative partnerships with OR personnel. Sales professionals' effectiveness is strengthened as a result of their newly acquired knowledge of OR protocol, and patient safety is protected. An AORN Certificate of Recognition is awarded on completion of the course.

  16. Trend Analyses of Users of a Syringe Exchange Program in Philadelphia, Pennsylvania: 1999-2014.

    Science.gov (United States)

    Maurer, Laurie A; Bass, Sarah Bauerle; Ye, Du; Benitez, José; Mazzella, Silvana; Krafty, Robert

    2016-12-01

    This study examines trends of injection drug users' (IDUs) use of a Philadelphia, Pennsylvania, syringe exchange program (SEP) from 1999 to 2014, including changes in demographics, drug use, substance abuse treatment, geographic indicators, and SEP use. Prevention Point Philadelphia's SEP registration data were analyzed using linear regression, Pearson's Chi square, and t-tests. Over time new SEP registrants have become younger, more racially diverse, and geographically more concentrated in specific areas of the city, corresponding to urban demographic shifts. The number of new registrants per year has decreased, however syringes exchanged have increased. Gentrification, cultural norms, and changes in risk perception are believed to have contributed to the changes in SEP registration. Demographic changes indicate outreach strategies for IDUs may need adjusting to address unique barriers for younger, more racially diverse users. Implications for SEPs are discussed, including policy and continued ability to address current public health threats.

  17. 29 CFR 779.327 - Wholesale sales.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Wholesale sales. 779.327 Section 779.327 Labor Regulations... Particular Industryâ § 779.327 Wholesale sales. A wholesale sale, of course, is not recognized as a retail sale. If an establishment derives more than 25 percent of its annual dollar volume from sales made at...

  18. Tracking sales activities in agribusiness

    OpenAIRE

    Li, Jiayu

    2015-01-01

    Decisions in the sales area, including customer and product selection and margin discipline, shape profits for companies in agribusiness. Management of the sales function takes place at the organizational, managerial, and practitioner level, each of which requires data about the process. Individual salespeople benefit from better knowledge of customers (Dixon & Adamson, 2011), and sales managers benefit from understanding the activities of salespeople. Organizationally, data on sales activiti...

  19. 13 CFR 120.433 - What are SBA's other requirements for sales and sales of participating interests?

    Science.gov (United States)

    2010-01-01

    ... for sales and sales of participating interests? 120.433 Section 120.433 Business Credit and Assistance... requirements for sales and sales of participating interests? SBA requires the following: (a) The Lender must be... include, but are not limited to, on-site review/examination assessments, historical performance measures...

  20. THE REQUIRED FORM OF A PRE-CONTRACT ALLOWING FOR A COURT JUDGMENT TO STAND FOR A SALE CONTRACT

    Directory of Open Access Journals (Sweden)

    Delia Narcisa THEOHARI

    2017-05-01

    Full Text Available A bilateral promissory agreement for sale needs no notarial deed to constitute, in case of non-fulfillment, grounds for the delivery of a judgment which takes the place of a sale contract, a private agreement being sufficient whereas the judgment itself represents the sale contract and both the substantive and formal conditions are therefore satisfied.

  1. 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.

  2. What constitutes the gas sales contract in the evolving marketplace?

    International Nuclear Information System (INIS)

    Hughes, T.M.

    1996-01-01

    A general overview of certain fundamental issues of contract law, which are relevant to gas sales transactions, was presented. Since deregulation, parties of the Canadian natural gas market are free to negotiate the terms of arrangements and contracts with any number of buyers and sellers. With deregulation also came a substantial increase in the amount of litigation regarding sales contracts. Two basic issues that should be kept in mind when negotiating any gas sales contract were letter agreements, (two versions of non-binding letters of intent), and requirement of writing. Within the requirements of writing one should be mindful of the legal implications of the fraud statutes, the Sale of Goods Act, what constitutes a sufficient note or memorandum, what constitutes the requisite signature, contracting out of the requirement of writing and signature on the mass agreement, certainty of terms, and the terms implied by legislation. It was considered advantageous for both buyers and sellers to continue to be vigilant about the contractual arrangements respecting all of their gas transactions

  3. Contact with hospital syringes containing body fluids: implications for medical waste management regulation Jeringas en contacto con sangre y fluidos corporales utilizadas en el hospital: implicaciones para el manejo de desechos hospitalarios

    OpenAIRE

    Patricia Volkow; Bénédicte Jacquemin; Diana Vilar-Compte; José Ramón Castillo

    2003-01-01

    OBJECTIVE: To determine amount of syringes used in the hospital and extent of contact with blood and body fluids of these syringes. MATERIAL AND METHODS: Syringe use was surveyed at a tertiary care center for one week; syringes were classified into the following four categories according to use: a) contained blood; b) contained other body fluids (urine, gastric secretion, cerebrospinal fluid, wound drainage); c) used exclusively for drug dilution and application in plastic intravenous (IV) tu...

  4. 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…

  5. Regulation of antibiotic sales in Mexico: an analysis of printed media coverage and stakeholder participation.

    Science.gov (United States)

    Dreser, Anahí; Vázquez-Vélez, Edna; Treviño, Sandra; Wirtz, Veronika J

    2012-12-06

    Restricting antibiotics sales to those with medical prescriptions only is a central strategy for promoting appropriate use and containing antibiotic resistance; however, many low and middle income countries have not enforced policies that prevent widespread self-medication with antibiotics. In 2010, the Mexican government announced the enforcement of antibiotic sales regulations, a policy that gained media prominence. This study analyzes media coverage of issues, stakeholder representation, and positions taken during policy agenda setting, drafting, and implementation to shed light on policy making to promote appropriate antibiotic utilization. We carried out a quantitative content analysis of 322 newspaper articles published between January 2009 and December 2010 in 18 national and regional newspapers. Additionally, we conducted a qualitative content analysis to understand the positions adopted and strategies developed by nine key stakeholders. Framing theory guided the analysis. The Ministry of Health dominated media coverage, justifying the enforcement policy by focusing on risks of self-medication, and to a lesser degree dangers of increasing antibiotic resistance. Pharmacy associations appeared to be the leading opponents, arguing that the policy created logistical difficulties and corruption, and had negative economic impact for pharmacies and their clients. The associations developed strategies against the regulation such as attempting to delay implementation and installing physicians' consultation offices within pharmacies. While medical associations and academic institutions called for a comprehensive strategy to combat antibiotic resistance, improve prescription quality, and create public awareness, these issues had little impact on media coverage. Consumer groups and legislators received very little media coverage. The narrowly-focused and polarized media coverage ─centred on problems of self- medication and economic impact ─ was a missed opportunity

  6. Regulation of antibiotic sales in Mexico: an analysis of printed media coverage and stakeholder participation

    Directory of Open Access Journals (Sweden)

    Dreser Anahí

    2012-12-01

    Full Text Available Abstract Background Restricting antibiotics sales to those with medical prescriptions only is a central strategy for promoting appropriate use and containing antibiotic resistance; however, many low and middle income countries have not enforced policies that prevent widespread self-medication with antibiotics. In 2010, the Mexican government announced the enforcement of antibiotic sales regulations, a policy that gained media prominence. This study analyzes media coverage of issues, stakeholder representation, and positions taken during policy agenda setting, drafting, and implementation to shed light on policy making to promote appropriate antibiotic utilization. Methods We carried out a quantitative content analysis of 322 newspaper articles published between January 2009 and December 2010 in 18 national and regional newspapers. Additionally, we conducted a qualitative content analysis to understand the positions adopted and strategies developed by nine key stakeholders. Framing theory guided the analysis. Results The Ministry of Health dominated media coverage, justifying the enforcement policy by focusing on risks of self-medication, and to a lesser degree dangers of increasing antibiotic resistance. Pharmacy associations appeared to be the leading opponents, arguing that the policy created logistical difficulties and corruption, and had negative economic impact for pharmacies and their clients. The associations developed strategies against the regulation such as attempting to delay implementation and installing physicians’ consultation offices within pharmacies. While medical associations and academic institutions called for a comprehensive strategy to combat antibiotic resistance, improve prescription quality, and create public awareness, these issues had little impact on media coverage. Consumer groups and legislators received very little media coverage. Conclusions The narrowly-focused and polarized media coverage ─centred on

  7. Determinants and antecedents of sales organization effectiveness

    Directory of Open Access Journals (Sweden)

    Andrea Razum

    2011-12-01

    Full Text Available The fundamental objective of this paper was to identify and analyze the main antecedents of sales organization effectiveness in order to offer the guidelines for improving the standard sales practice. In addition to the customary challenges of achieving anticipated sales results, rising pressures of the contemporary business environment underscore the importance of establishing a more effective sales organization. The aim of the empirical research was to identify the sources of effectiveness of sales organizations based on the comparison between two groups of organizations, namely, the relatively high and low performing ones. The concept of sales performance was observed through five distinct factors: sales management activities, sales force characteristics, sales organization design and sales force effectiveness with regard to the sales outcome of these organizations and their behavior. The analysis of the results led to the conclusion that the most important sources of sales effectiveness are the activities of sales managers targeted towards monitoring and rewarding. Moreover, sales managers in relatively more effective organizations reported much higher satisfaction with the design of sales territories. Sales people in effective companies are highly motivated and committed to the organization. In addition, they are also considerably better at achieving high levels of outcome performance. The research presents an addition to a number of similar studies conducted worldwide but, more importantly, it contributes to the exceptionally small number of sales management studies carried out in Croatia. For a more complete analysis it would be necessary to include the variables of the external environment and examine the potential moderating impact of product type and industry on the overall sales effectiveness.

  8. Electric sales and revenue: 1993

    Energy Technology Data Exchange (ETDEWEB)

    1995-01-01

    The Electric Sales and Revenue is prepared by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels; Energy Information Administration (EIA); US Department of Energy. This publication provides information about sales of electricity, its associated revenue, and the average revenue per kilowatthour sold to residential, commercial, industrial, and other consumers throughout the United States. The sales, revenue, and average revenue per kilowatthour data provided in the Electric Sales and Revenue are based on annual data reported by electric utilities for the calendar year ending December 31, 1993. Operating revenue includes energy charges, demand charges, consumer service charges, environmental surcharges, fuel adjustments, and other miscellaneous charges. The revenue does not include taxes, such as sales and excise taxes, that are assessed on the consumer and collected through the utility. Average revenue per kilowatthour is defined as the cost per unit of electricity sold and is calculated by dividing retail sales into the associated electric revenue. Because electric rates vary based on energy usage, average revenue per kilowatthour are affected by changes in the volume of sales. The sales of electricity, associated revenue, and average revenue per kilowatthour data provided in this report are presented at the national, Census division, State, and electric utility levels.

  9. Sales-as-Practice: An Introduction and Methodological Outline to Study Sales Work

    OpenAIRE

    Geiger, Susi; Kelly, Séamas

    2014-01-01

    There are strong indications that sales practices are currently being redefined from the ground up and that many of the inherited conceptual models of selling will not hold into a future that is defined by new selling techniques and technologies. This paper introduces a research perspective that can provide an important source of insight into how sales work and salespeople are currently being reconstituted: the sales-as-practice approach. In common with 'practice turns' evident in other busin...

  10. The impact of harm reduction programs and police interventions on the number of syringes collected from public spaces. A time series analysis in Barcelona, 2004-2014.

    Science.gov (United States)

    Espelt, A; Villalbí, J R; Bosque-Prous, M; Parés-Badell, O; Mari-Dell'Olmo, M; Brugal, M T

    2017-12-01

    To estimate the effect of opening two services for people who use drugs and three police interventions on the number of discarded syringes collected from public spaces in Barcelona between 2004 and 2014. We conducted an interrupted time-series analysis of the monthly number of syringes collected from public spaces during this period. The dependent variable was the number of syringes collected per month. The main independent variables were month and five dummy variables (the opening of two facilities with safe consumption rooms, and three police interventions). To examine which interventions affected the number of syringes collected, we performed an interrupted time-series analysis using a quasi-Poisson regression model, obtaining relative risks (RR) and 95% confidence intervals (CIs). The number of syringes collected per month in Barcelona decreased from 13,800 in 2004 to 1655 in 2014 after several interventions. For example, following the closure of an open drug scene in District A of the city, we observed a decreasing trend in the number of syringes collected [RR=0.88 (95% CI: 0.82-0.95)], but an increasing trend in the remaining districts [RR=1.11 (95% CI: 1.05-1.17) and 1.08 (95% CI: 0.99-1.18) for districts B and C, respectively]. Following the opening of a harm reduction facility in District C, we observed an initial increase in the number collected in this district [RR=2.72 (95% CI: 1.57-4.71)] and stabilization of the trend thereafter [RR=0.97 (95% CI: 0.91-1.03)]. The overall number of discarded syringes collected from public spaces has decreased consistently in parallel with a combination of police interventions and the opening of harm reduction facilities. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. 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.

  12. Determination of bismuth and cadmium after solid-phase extraction with chromosorb-107 in a syringe

    International Nuclear Information System (INIS)

    Tokman, Nilgun; Akman, Suleyman

    2004-01-01

    The determination of bismuth and cadmium by graphite furnace atomic absorption spectrometry (GFAAS) after solid-phase extraction (SPE) on Chromosorb-107 filled in a syringe was described. To retain the analytes, the sample solution treated with and without ammonium pyrolidine dithiocarbamate (APDC) was drawn into the syringe filled with Chromosorb-107 and discharged back manually. Bismuth and cadmium were quantitatively sorbed at pH ≥ 6 irrespective of whether the analyte was complexed with APDC prior to passing through the Chromosorb-107. Analyte elements sorbed on the resin were quantitatively eluted with 3.0 M of HNO 3 again drawing and discharging the eluent into the syringe and ejected it back. Optimum flow rates of sample or eluent for sorption and elution processes were 20 ml min -1 for drawing and 20 ml min -1 for discharging in all cases. Bismuth and cadmium were analyzed by graphite furnace atomic absorption spectrometry. The elements could be concentrated by drawing and discharging several portions of sample successively but eluting only one time. The validity of the proposed method was checked with standard reference materials (NIST SRM 1515 Apple-Leaves, CWW-TM-E Waste Water and CRM-SW Sea Water). The analyte elements were quantitatively (>95%) recovered from different matrices irrespective of treated samples with APDC. Detection limits (δ) were 0.8 and 1.2 μg l -1 for Bi and Cd, respectively. The method can be characterized with fastness, simplicity, quantitative recovery and high reproducibility

  13. Syringe shape and positioning relative to efficiency volume inside dose calibrators and its role in nuclear medicine quality assurance programs

    International Nuclear Information System (INIS)

    Santos, J.A.M.; Carrasco, M.F.; Lencart, J.; Bastos, A.L.

    2009-01-01

    A careful analysis of geometry and source positioning influence in the activity measurement outcome of a nuclear medicine dose calibrator is presented for 99m Tc. The implementation of a quasi-point source apparent activity curve measurement is proposed for an accurate correction of the activity inside several syringes, and compared with a theoretical geometric efficiency model. Additionally, new geometrical parameters are proposed to test and verify the correct positioning of the syringes as part of acceptance testing and quality control procedures.

  14. Syringe shape and positioning relative to efficiency volume inside dose calibrators and its role in nuclear medicine quality assurance programs

    Energy Technology Data Exchange (ETDEWEB)

    Santos, J.A.M. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Centro de Investigacao, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal)], E-mail: a.miranda@portugalmail.pt; Carrasco, M.F. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Centro de Investigacao, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Lencart, J. [Servico de Fisica Medica, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal); Bastos, A.L. [Servico de Medicina Nuclear, Instituto Portugues de Oncologia do Porto Francisco Gentil, E.P.E., Rua Dr. Antonio Bernardino de Almeida, 4200072 Porto (Portugal)

    2009-06-15

    A careful analysis of geometry and source positioning influence in the activity measurement outcome of a nuclear medicine dose calibrator is presented for {sup 99m}Tc. The implementation of a quasi-point source apparent activity curve measurement is proposed for an accurate correction of the activity inside several syringes, and compared with a theoretical geometric efficiency model. Additionally, new geometrical parameters are proposed to test and verify the correct positioning of the syringes as part of acceptance testing and quality control procedures.

  15. Dispensing of non-prescribed antibiotics in Jordan

    Directory of Open Access Journals (Sweden)

    Almaaytah A

    2015-09-01

    Full Text Available Ammar Almaaytah,1 Tareq L Mukattash,2 Julia Hajaj2 1Department of Pharmaceutical Technology, 2Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan Objective: Current regulations in Jordan state that antibiotics cannot be sold without a medical prescription. This study aimed to assess the percentage of pharmacies that dispense antibiotics without a medical prescription in the Kingdom of Jordan and identify and highlight the extent and seriousness of such practices among Jordanian pharmacies. Methods: A prospective study was performed, and five different clinical scenarios were simulated at pharmacies investigated including sore throat, otitis media, acute sinusitis, diarrhea, and urinary tract infection in childbearing-aged women. Three levels of demand were used to convince the pharmacists to sell an antibiotic. Results: A total of 202 total pharmacies in Jordan were visited in the present study. The majority of pharmacies (74.3% dispensed antibiotics without prescription with three different levels of demand. The percentage of pharmacies dispensing antibiotics without a prescription for the sore throat scenario was 97.6%, followed by urinary tract infection (83.3%, diarrhea (83%, and otitis media (68.4%. The lowest percentage of antibiotic dispensing was for the acute sinusitis simulation at 48.5%. Among the pharmacies that dispensed antibiotics, the pharmacists provided an explanation as the number of times per day the drug should be taken in 95.3% of the cases, explained the duration of treatment in 25.7%, and inquired about allergies prior to the sale of the antibiotic in only 17.3%. Only 52 pharmacies (25.7% refused to dispense any kind of antibiotics, the majority (61.5% of this refusal response came from acute sinusitis cases, while the minority (2.4% came from the sore throat cases. Conclusion: The results of this study demonstrate that antibiotics continue to be dispensed

  16. Motives for nonmedical use of prescription opioids among high school seniors in the United States: self-treatment and beyond.

    Science.gov (United States)

    McCabe, Sean Esteban; Boyd, Carol J; Cranford, James A; Teter, Christian J

    2009-08-01

    To assess motives for nonmedical use of prescription opioids among US high school seniors and examine associations between motives for nonmedical use and other substance use behaviors. Nationally representative samples of US high school seniors (modal age 18 years) were surveyed during the spring of their senior year via self-administered questionnaires. Data were collected in public and private high schools. The sample consisted of 5 cohorts (2002-2006) of 12 441 high school seniors. Self-reports of motives for nonmedical use of prescription opioids and substance use behaviors. More than 1 in every 10 high school seniors reported nonmedical use of prescription opioids and 45% of past-year nonmedical users reported "to relieve physical pain" as an important motivation. The odds of heavy drinking and other drug use were lower among nonmedical users of prescription opioids motivated only by pain relief compared with nonmedical users who reported pain relief and other motives and those who reported non-pain relief motives only. The odds of medical use of prescription opioids were lower among nonmedical users who reported only non-pain relief motives compared with other types of nonmedical users. The findings indicate motives should be considered when working with adolescents who report nonmedical use of prescription opioids. Future efforts are needed to identify adolescents who may need appropriate pain management and those at increased risk for prescription opioid abuse.

  17. Enhancing the Professional Mindset of Future Sales Professionals: Key Insights from a Master in Sales Transformation

    Science.gov (United States)

    Marcos-Cuevas, Javier; Critten, Peter; Squire, Phil; Speakman, James I. F.

    2014-01-01

    Sales education has grown in importance, particularly throughout the last decade, with an increasing number of university sales centers offering programs to prepare new generations of sales professionals. In this article, we describe how work-based learning, action research, and reflective practice used in a sales master program can be used in…

  18. The Misuse of Prescription Opioids: A Threat for Europe?

    NARCIS (Netherlands)

    van Amsterdam, Jan; van den Brink, Wim

    2015-01-01

    In the the past two decades the medical use of prescription opioids (POs), in particular oxycodone, increased up to 14-fold in the U.S. and Canada. The high consumption of these pain relievers also led to non-medical use and abuse of these substances which in turn resulted in a dramatic increase in

  19. INFORMATION TECHNOLOGIES IN INSURANCE SALES SUPPORT

    Directory of Open Access Journals (Sweden)

    Stofor Ovidiu-Ilie

    2012-07-01

    Full Text Available Insurance system in Romania is carried out with a constant natural activity, evolving quite honorably these times. This is largely due to the difficulty with which insurance is sold in normal economic conditions when it comes to prosperity. Although psychologists, led by Maslow believes that the protection needs are basic needs, along with the physiological one, on the priority list regarding procurement, insurance needs are for some Romanians, of minimum or no importance, so that they are either pushed to the bottom of the list, or even, as it most often happens, they are non existent. Current economic conditions and climate, urges caution on most fields, especially in terms of individual properties, including, how somewhat forced, life and physical integrity which are still considered property, if this aspect is not debated in terms of Christian or other religious dogma. In other words, many Romanians see insurance as a product that “is not up their alley” including it in the luxury category. Furthermore, the media shows, sometimes amplify certain cases of doubt in relations between insurance company - customer. Appropriate marketing, allied with the information technology can improve the complete relationship between the two entities - the offeror and the consumer. Through this study we aim to identify important issues that facilitate the sale of insurance, using information technology, given that the sales of these financial products through the "ancestral" methods are effective but not very efficient. We will follow, byanchoring to the current reality, the insurance utility and how to use information technologies in support of marketing (sales. The study itself was done by observing the results in practical work, from an insurance agency, but also related to what the literature offers. Because this study is currently underway, there are certainly some limitations of accuracy of results, which are adjusted "on the fly". Realizing

  20. Sales Territory Alignment: A Review and Model

    OpenAIRE

    Andris A. Zoltners; Prabhakant Sinha

    1983-01-01

    The sales territory alignment problem may be viewed as the problem of grouping small geographic sales coverage units into larger geographic clusters called sales territories in a way that the sales territories are acceptable according to managerially relevant alignment criteria. This paper first reviews sales territory alignment models which have appeared in the marketing literature. A framework for sales territory alignment and several properties of a good sales territory alignment are devel...

  1. Use of electronic sales data to tailor nutrition education resources for an ethnically diverse population.

    Science.gov (United States)

    Eyles, H; Rodgers, A; Ni Mhurchu, C

    2010-02-01

    Nutrition education may be most effective when personally tailored. Individualised electronic supermarket sales data offer opportunities to tailor nutrition education using shopper's usual food purchases. The present study aimed to use individualised electronic supermarket sales data to tailor nutrition resources for an ethnically diverse population in a large supermarket intervention trial in New Zealand. Culturally appropriate nutrition education resources (i.e. messages and shopping lists) were developed with the target population (through two sets of focus groups) and ethnic researchers. A nutrient database of supermarket products was developed using retrospective sales data and linked to participant sales to allow tailoring by usual food purchases. Modified Heart Foundation Tick criteria were used to identify 'healthier' products in the database suitable for promotion in the resources. Rules were developed to create a monthly report listing the tailored and culturally targeted messages to be sent to each participant, and to produce automated, tailored shopping lists. Culturally targeted nutrition messages (n = 864) and shopping lists (n = 3 formats) were developed. The food and nutrient database (n = 3000 top-selling products) was created using 12 months of retrospective sales data, and comprised 60%'healthier' products. Three months of baseline sales data were used to determine usual food purchases. Tailored resources were successfully mailed to 123 Māori, 52 Pacific and 346 non-Māori non-Pacific participants over the 6-month trial intervention period. Electronic supermarket sales data can be used to tailor nutrition education resources for a large number of ethnically diverse supermarket shoppers.

  2. Variations in the sales and sales patterns of veterinary antimicrobial agents in 25 European countries.

    Science.gov (United States)

    Grave, Kari; Torren-Edo, Jordi; Muller, Arno; Greko, Christina; Moulin, Gerard; Mackay, David

    2014-08-01

    To describe sales and sales patterns of veterinary antimicrobial agents in 25 European Union (EU)/European Economic Area (EEA) countries for 2011. Data on the sales of veterinary antimicrobial agents from 25 EU member states and EEA countries for 2011 were collected at package level (name, formulation, strength, pack size, number of packages sold) according to a standardized protocol and template and presented in a harmonized manner. These data were calculated to express amounts sold, in metric tonnes, of active ingredient of each package. A population correction unit (PCU) was applied as a proxy for the animal biomass potentially treated with antimicrobial agents. The indicator used to express sales was milligrams of active substance per PCU. Substantial variations in the sales patterns and in the magnitude of sales of veterinary antimicrobial agents, expressed as mg/PCU, between the countries were observed. The proportion of sales, in mg/PCU, of products applicable for treatment of groups or herds of animals (premixes, oral powders and oral solution) varied considerably between the countries. Some countries reported much lower sales of veterinary antimicrobial agents than others, when expressed as mg/PCU. Sales patterns varied between countries, particularly with respect to pharmaceutical forms. Further studies are needed to understand the factors that explain the observed differences. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  3. From manager’s emotional intelligence to objective store performance : Through store cohesiveness and sales-directed employee behavior

    NARCIS (Netherlands)

    Wilderom, C.P.M.; Hur, Y.; Wiersma, U.J.; van den Berg, Petrus; Lee, J.

    2015-01-01

    The relationships among manager's emotional intelligence, store cohesiveness, sales-directed employee behavior, and objective store performance were investigated. Non-managerial sales employees of a large retail electronics chain in South Korea (N = 1611) rated the emotional intelligence of their

  4. Sales Promotion and Consumer Loyalty: A Study of Nigerian Tecommunication Industry

    Directory of Open Access Journals (Sweden)

    Oyeniyi Omotayo

    2011-12-01

    Full Text Available In today’s competitive business world customers are considered to be kings. Customers have several choices to make among alternative products, and they exercise a high level of influence in the market with respect to product size, quality and price. Hence, it is important for producers to meet the needs of customers in order to stay competitive. One of the marketing communication tools that is used in attracting the attention of the customer and build their loyalty is sales promotion. The aim of this paper therefore is to determine the effect of sales promotion on customer loyalty in the telecommunication industry. In this study, the survey method was used in gathering information from the respondents. Simple random sampling was used to select a sample size of 310, while descriptive and inferential statistical analyses were conducted with the aid of SPSS software. Producers spend a large part of their total marketing communication expenses on sales promotion. Hence, this paper attempts to find the effect of sales promotion on customer loyalty using a sample of customers of mobile telecommunication services. The paper found that, there is positive relationship between sales promotion and customer loyalty. More importantly, it was discovered that non-loyal customers are more prone to switch to competing products as a result of sales promotion than loyal customers.

  5. 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

  6. Prevalence of and Comorbid Health Conditions Associated With Pediatric Prescription Opioid Use in the US.

    Science.gov (United States)

    Banerjee, Souvik; Roland, Carl L; Willke, Richard; Mardekian, Jack; Garrison, Louis P

    Prescription opioids are among the most effective analgesics to treat moderate to severe pain; however, little is known about the use of prescription opioids in children, particularly those receiving an extended-release formulation for the treatment of chronic pain. In this retrospective study, the authors determined the prevalence of prescription opioid use among 7-17-year-old children and associated comorbid health conditions from 2010 to 2013 using Truven Health MarketScan (MarketScan) and Optum Clinformatics DataMart (Optum). The primary end points were prevalence of using any prescription opioids, using only prescription short-acting opioids (SAOs), and at least one prescription of a long-acting opioid (LAO). The prevalence of prescription opioid use among children is non-negligible and has been trending downwards: 6.90% in 2010 and 5.93% in 2013 using MarketScan and a similar trend using Optum: 5.47% in 2010 and 4.51% in 2013. Very few children had claims for LAOs, with only 0.04% (4979 children) in MarketScan and 0.03% (1117 children) in Optum. Given the very small number of children, primarily in the 12-17 age group, who are prescribed LAOs, there is a need to focus on a better understanding of the patterns of SAO use in children.

  7. Physical stability of 20% lipid injectable emulsions via simulated syringe infusion: effects of glass vs plastic product packaging.

    Science.gov (United States)

    Driscoll, David F; Ling, Pei-Ra; Bistrian, Bruce R

    2007-01-01

    The United States Pharmacopeia (USP) has proposed large-globule-size limits to ensure the physical stability of lipid injectable emulsions, expressed as the percent fat >5 microm, or PFAT(5), not exceeding 0.05%. Visibly obvious phase separation as free oil has been shown to occur in some samples if PFAT(5) is >0.4%. We recently found that lipids, newly packaged in plastic (P), exceed the proposed USP limits and seem to produce less stable total nutrient admixtures compared with those made from conventional glass (G), which do meet proposed USP standards. We tested the possible stability differences between 20% lipid injectable emulsions in either P or G in a simulated neonatal syringe infusion study. Eighteen individual syringes were prepared from each 20% lipid injectable emulsion product (n = 36) and attached to a syringe pump set at an infusion rate of 0.5 mL/hour. The starting PFAT(5) levels were measured at time 0 and after 24 hours of infusion, using a laser-based light obscuration technique as described by the USP Chapter . The data were assessed by a 2-way analysis of variance (ANOVA) with Container (G vs P) and Time as the independent variables and PFAT as the dependent variable. At time 0, the starting PFAT(5) level for lipids packaged in G was 0.006% +/- 0.001% vs 0.162% +/- 0.026% for P, whereas at the end of the infusion they were 0.013% +/- 0.003% and 0.328% +/- 0.046%, respectively. Significant differences were noted overall between groups for Container, Time, and Container-Time interaction (all p emulsions packaged in newly introduced plastic containers exceed the proposed USP PFAT(5) limits and subsequently become significantly less stable during a simulated syringe-based infusion. Although modest growth (p = NS) in large-diameter fat globules was observed for the glass-based lipids, they remained within proposed USP globule size limits throughout the study. Glass-based lipids seem to be a more stable dosage form and potentially a safer way to

  8. [Dangerous liaisons--physicians and pharmaceutical sales representatives].

    Science.gov (United States)

    Granja, Mónica

    2005-01-01

    Interactions between physicians and detailers (even when legitimate ones) raise scientific and ethical questions. In Portugal little thinking and discussion has been done on the subject and the blames for bribery have monopolized the media. This work intended to review what has been said in medical literature about these interactions. How do physicians see themselves when interacting with pharmaceutical companies and their representatives? Do these companies in fact change their prescriptive behaviour, and, if so, how do they change it? How can physicians interact with detailers and still keep their best practice? A Medline research, from 1966 till 2002, was performed using the key-words as follows. A database similar to Medline but concerning medical journals published in Portugal, Index das Revistas Médicas Portuguesas, was also researched from 1992 to 2002. Pharmaceutical companies are profit bound and they allot promoting activities, and detailing in particular, huge amounts of money. Most physicians hold firmly to the belief that they are able to resist and not be influenced by drug companies promotion activities. Nevertheless, all previous works on literature tell us the opposite. Market research also indicates that detailers effectively promote drug sales. Various works also suggest that the information detailers provide to physicians may be largely incorrect, even comparing it to the written information provided by the pharmaceutical companies they work for. The frequency at which portuguese physicians (especially family physicians) contact with pharmaceutical sales representatives is higher than the frequency reported in countries where the available studies come from (namely, Canada and the United States of America). This may put portuguese physicians at a higher risk, making it imperative that work and wide debate are initiated among the class.

  9. 48 CFR 245.7306 - Sales services.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Sales services. 245.7306... OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Sale of Surplus Contractor Inventory 245.7306 Sales services. When sale services are needed, the plant clearance officer will document the reasons in...

  10. 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...

  11. Pharmacy Malpractice: The rate and prevalence of dispensing high-risk prescription-only medications at community pharmacies in Saudi Arabia.

    Science.gov (United States)

    Alshammari, Thamir M; Alhindi, Salman A; Alrashdi, Ahmed M; Benmerzouga, Imaan; Aljofan, Mohamad

    2017-07-01

    To assess the compliance of community pharmacies with the regulations that prohibit the dispensing of prescription-only medications in the absence of a physician prescription in Saudi Arabia. A cross-sectional study was conducted in the period between October 2014 and January 2015. A list of 10 prescription-only medications were selected to be studied. 150 community pharmacies were visited across 6 major regions in Saudi Arabia to assess the prevalence of non-compliance among community pharmacies. Pharmacies were selected in random and researchers (disguised as patients) requested to purchase prescription-only medications in the absence of a prescription. Not all medications were purchased at once. Data were recorded per pharmacy, where pharmacies that approved dispense of the selected drug were scored as non-compliant and the pharmacies that rejected dispense of the selected drug were scored as compliant. Compliance rate was calculated per region per drug. Pharmacies based in governmental hospitals were visited in parallel. A total of 20 were visited. Data and statistical analysis were performed using Statistical Analyses Software (SAS 9.3). A total of 150 pharmacies were visited over a period of 3 months. On average, the percent approved dispense of prescription-only drugs across 6 regions in Saudi Arabia is 63% and the percent rejected dispense is 37% representing a significant non-compliance rate regarding the selected list of medications in this study. The frequency of dispense per medication across 6 major regions in Saudi Arabia is as follows: Isosorbide dinitrate (86%), Enoxaparin (82%), nitroglycerin (74%), Propranolol (73%), Verapamil (70%), Warfarin (65%), Methyldopa (64%), Ciprofloxacin (57%) and Codeine (4%). Non-compliance of community pharmacies with the law of pharmaceutical practice is at an alarming rate in the Kingdom of Saudi Arabia and authoritative figures must intervene to impede and combat such activities .

  12. 24 CFR 290.13 - Negotiated sales.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Negotiated sales. 290.13 Section... DEVELOPMENT HUD-OWNED PROPERTIES DISPOSITION OF MULTIFAMILY PROJECTS AND SALE OF HUD-HELD MULTIFAMILY MORTGAGES Disposition of Multifamily Projects § 290.13 Negotiated sales. When HUD conducts a negotiated sale...

  13. 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.

  14. 24 CFR 1715.25 - Misleading sales practices.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Misleading sales practices. 1715.25... URBAN DEVELOPMENT (INTERSTATE LAND SALES REGISTRATION PROGRAM) PURCHASERS' REVOCATION RIGHTS, SALES PRACTICES AND STANDARDS Sales Practices and Standards § 1715.25 Misleading sales practices. Generally...

  15. 40 CFR 73.72 - Direct sales.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Direct sales. 73.72 Section 73.72... ALLOWANCE SYSTEM Auctions, Direct Sales, and Independent Power Producers Written Guarantee § 73.72 Direct sales. Allowances that were formerly part of the direct sale program, which has been terminated under...

  16. 30 CFR 256.12 - Supplemental sales.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Supplemental sales. 256.12 Section 256.12..., General § 256.12 Supplemental sales. (a) The Secretary may conduct a supplemental sale in accordance with the provisions of this section. (b) Supplemental sales shall be governed by the regulations in this...

  17. [Preference for etanercept pen versus syringe in patients with chronic arthritis. Nurse education workshop].

    Science.gov (United States)

    Garcia-Diaz, Silvia; Girabent-Farrés, Montserrat; Roig-Vilaseca, Daniel; Reina, Delia; Cerdà, Dacia; González, Marina; Torrente-Segarra, Vicenç; Fíguls, Ramon; Corominas, Hèctor

    2013-01-01

    The aims of this study are to evaluate the level of fear of post-injection pain prior to the administration, the difficulty in handling the device, and the level of satisfaction of patients using a pre-filled syringe versus an etanercept pen, as well as to evaluate the usefulness of the training given by nursing staff prior to starting with the pen, and the preferences of patients after using both devices. A prospective study was designed to follow-up a cohort of patients during a 6 months period. The data was collected using questionnaires and analyzed with SPSS 18.00. Rank and McNemar tests were performed. Statistical significance was pre-set at an α level of 0.05. A total of 29 patients were included, of whom 69% female, and with a mean age 52.5±10.9 years. Of these, 48% had rheumatoid arthritis, 28% psoriatic arthritis, 21% ankylosing spondylitis, and 3% undifferentiated spondyloarthropathy. There were no statistically significant differences either with the fear or pain or handling of the device between the syringe and the pen (P=.469; P=.812; P=.169 respectively). At 6 months, 59% of patients referred to being satisfied or very satisfied with the pen. Almost all (93%) found useful or very useful the training given by nursing staff prior to using the pen, and 55% preferred the pen over the pre-filled syringe. The etanercept pen is another subcutaneous device option for patients with chronic arthritis. According to the present study, nursing educational workshops before starting this therapy are recommended. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  18. A two-stage procedure for determining unsaturated hydraulic characteristics using a syringe pump and outflow observations

    DEFF Research Database (Denmark)

    Wildenschild, Dorthe; Jensen, Karsten Høgh; Hollenbeck, Karl-Josef

    1997-01-01

    A fast two-stage methodology for determining unsaturated flow characteristics is presented. The procedure builds on direct measurement of the retention characteristic using a syringe pump technique, combined with inverse estimation of the hydraulic conductivity characteristic based on one......-step outflow experiments. The direct measurements are obtained with a commercial syringe pump, which continuously withdraws fluid from a soil sample at a very low and accurate how rate, thus providing the water content in the soil sample. The retention curve is then established by simultaneously monitoring......-step outflow data and the independently measured retention data are included in the objective function of a traditional least-squares minimization routine, providing unique estimates of the unsaturated hydraulic characteristics by means of numerical inversion of Richards equation. As opposed to what is often...

  19. 24 CFR 291.90 - Sales methods.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Sales methods. 291.90 Section 291....90 Sales methods. HUD will prescribe the terms and conditions for all methods of sale. HUD may, in... following methods of sale: (a) Future REO acquisition method. The Future Real Estate-Owned (REO) acquisition...

  20. 10 CFR 625.3 - Standard sales provisions.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Standard sales provisions. 625.3 Section 625.3 Energy DEPARTMENT OF ENERGY (CONTINUED) SALES REGULATION PRICE COMPETITIVE SALE OF STRATEGIC PETROLEUM RESERVE PETROLEUM § 625.3 Standard sales provisions. (a) Contents. The Standards Sales Provisions shall contain...

  1. Population prevalence of high dose paracetamol in dispensed paracetamol/opioid prescription combinations: an observational study

    Science.gov (United States)

    2012-01-01

    Background Paracetamol (acetaminophen) is generally considered a safe medication, but is associated with hepatotoxicity at doses above doses of 4.0 g/day, and even below this daily dose in certain populations. Methods The Nova Scotia Prescription Monitoring Program (NSPMP) in the Canadian province of Nova Scotia is a legislated organization that collects dispensing information on all out-of-hospital prescription controlled drugs dispensed for all Nova Scotia residents. The NSPMP provided data to track all paracetamol/opioids redeemed by adults in Nova Scotia, from July 1, 2005 to June 30, 2010. Trends in the number of adults dispensed these prescriptions and the numbers of prescriptions and tablets dispensed over this period were determined. The numbers and proportions of adults who filled prescriptions exceeding 4.0 g/day and 3.25 g/day were determined for the one-year period July 1, 2009 to June 30, 2010. Data were stratified by sex and age (paracetamol/opioid prescription was lower in each successive one-year period. From July 2009 to June 2010, one in 12 adults (n = 59,197) filled prescriptions for over 13 million paracetamol/opioid tablets. Six percent (n = 3,786) filled prescriptions that exceeded 4.0 g/day and 18.6% (n = 11,008) exceeded 3.25 g/day of paracetamol at least once. These findings exclude non-prescription paracetamol and paracetamol–only prescribed medications. Conclusions A substantial number of individuals who redeem prescriptions for paracetamol/opioid combinations may be at risk of paracetamol-related hepatotoxicity. Healthcare professionals must be vigilant when prescribing and dispensing these medications in order to reduce the associated risks. PMID:22709372

  2. 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

  3. 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

  4. 31 CFR 56.2 - Sales price.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Sales price. 56.2 Section 56.2 Money and Finance: Treasury Regulations Relating to Money and Finance DOMESTIC GOLD AND SILVER OPERATIONS SALE OF SILVER § 56.2 Sales price. Sales of silver will be at prices offered through the competitive...

  5. Fuel oil and kerosene sales 1994

    International Nuclear Information System (INIS)

    1995-01-01

    This publication contains the 1994 survey results of the ''Annual Fuel Oil and Kerosene Sales Report'' (Form EIA-821). This is the sixth year that the survey data have appeared in a separate publication. Prior to the 1989 report, the statistics appeared in the Petroleum Marketing Annual (PMA)for reference year 1988 and the Petroleum Marketing Monthly (PMM) for reference years 1984 through 1987. The 1994 edition marks the 11th annual presentation of the results of the ongoing ''Annual Fuel Oil and Kerosene Sales Report'' survey. Distillate and residual fuel oil sales continued to move in opposite directions during 1994. Distillate sales rose for the third year in a row, due to a growing economy. Residual fuel oil sales, on the other hand, declined for the sixth year in a row, due to competitive natural gas prices, and a warmer heating season than in 1993. Distillate fuel oil sales increased 4.4 percent while residual fuel oil sales declined 1.6 percent. Kerosene sales decreased 1.4 percent in 1994

  6. [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.

  7. 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…

  8. Drivers of peak sales for pharmaceutical brands

    NARCIS (Netherlands)

    Fischer, Marc; Leeflang, Peter S. H.; Verhoef, Peter C.

    2010-01-01

    Peak sales are an important metric in the pharmaceutical industry. Specifically, managers are focused on the height-of-peak-sales and the time required achieving peak sales. We analyze how order of entry and quality affect the level of peak sales and the time-to-peak-sales of pharmaceutical brands.

  9. Key personality traits of sales managers.

    Science.gov (United States)

    Lounsbury, John W; Foster, Nancy A; Levy, Jacob J; Gibson, Lucy W

    2014-01-01

    Sales managers are crucial for producing positive sales outcomes for companies. However, there has been a relative dearth of scholarly investigations into the personal attributes of sales managers. Such information could prove important in the recruitment, selection, training needs identification, career planning, counseling, and development of sales managers. Drawing on Holland's vocational theory, we sought to identify key personality traits that distinguish sales managers from other occupations and are related to their career satisfaction. The main sample was comprised of a total of 978 sales managers employed in a large number of companies across the United States (along with a comparison sample drawn from 79,512 individuals from other professional occupations). Participants completed an online version of Resource Associates' Personal Style Inventory as well a measure of career satisfaction. Our sample of 978 sales managers had higher levels of Assertiveness, Customer Service Orientation, Extraversion, Image Management, Optimism, and Visionary Style; and lower levels of Conscientiousness, Agreeableness, Intrinsic Motivation, Openness, and Tough-Mindedness than a sample of 79,512 individuals in a variety of other occupations. Nine of these traits were significantly correlated with sales managers' career satisfaction. Based on the results, a psychological profile of sales managers was presented as were implications for their recruitment, selection, training, development, and mentoring.

  10. 40 CFR 73.73 - Delegation of auctions and sales and termination of auctions and sales.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Delegation of auctions and sales and termination of auctions and sales. 73.73 Section 73.73 Protection of Environment ENVIRONMENTAL PROTECTION... Independent Power Producers Written Guarantee § 73.73 Delegation of auctions and sales and termination of...

  11. Electric sales and revenue, 1990

    International Nuclear Information System (INIS)

    1992-01-01

    The Electric Sales and Revenue is prepared by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels; Energy Information Administration (EIA); US Department of Energy. This publication provides information about sales of electricity, its associated revenue, and the average revenue per kilowatthour sold to residential, commercial, industrial, and other consumers throughout the United States. Previous publications presented data on typical electric bills at specified consumption levels as well as sales, revenues, and average revenue. The sales, revenue, and average revenue per kilowatthour provided in the Electric Sales and Revenue are based on annual data reported by electric utilities for the calendar year ending December 31, 1990. The electric revenue reported by each electric utility includes the revenue billed for the amount of kilowatthours sold, revenue from income, unemployment and other State and local taxes, energy or demand charges, consumer services charges, environmental surcharges, franchise fees, fuel adjustments, and other miscellaneous charges. Average revenue per kilowatthour is defined as the cost per unit of electricity sold and is calculated by dividing retail sales into the associated electric revenue. The sales of electricity, associated revenue, and average revenue per kilowatthour provided in this report are presented at the national, Census division, State, and electric utility levels

  12. Allostatic dysregulation of natural reward processing in prescription opioid misuse: autonomic and attentional evidence.

    Science.gov (United States)

    Garland, Eric L; Froeliger, Brett; Howard, Matthew O

    2015-02-01

    Chronic pain patients who misuse prescription opioids may suffer from allostatic dysregulation of natural reward processing. Hence, this study examined whether prescription opioid misusers with chronic pain (n=72) evidenced decreased natural reward responsiveness relative to non-misusers with chronic pain (n=26). Subjects completed a dot probe task containing pain-related, opioid-related, and natural reward stimuli while attentional bias (AB) scores and heart rate variability (HRV) responses were assessed. Compared to non-misusers, misusers evidenced significantly more attenuated HRV responses to opioid, pain, and natural reward cues presented during the dot probe task. These significant between-groups differences in HRV were largest during attention to natural reward cues, but became non-significant in a sensitivity analysis controlling for opioid dosing. In addition, non-misusers evidenced an AB toward natural reward cues, whereas misusers did not. Findings suggest that opioid misusers exhibit attentional and autonomic deficits during reward processing. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Effectiveness of Three Different Walking Prescription Durations on Total Physical Activity in Normal- and Overweight Women

    Directory of Open Access Journals (Sweden)

    Yves Schutz

    2014-08-01

    Full Text Available Objective: While there is a dose-response relationship between physical activity (PA and health benefit, little is known about the effectiveness of different PA prescriptions on total daily PA. Aim: To test, under real-life conditions and using an objective, non-invasive measurement technique (accelerometry, the effect of prescribing additional physical activity (walking only of different durations (30, 60 and 90 min/day on compliance (to the activity prescribed and compensation (to total daily PA. Participants in each group were prescribed 5 sessions of walking per week over 4 weeks. Methods: 55 normal-weight and overweight women (mean BMI 25 ± 5 kg/m2, height 165 ± 1 cm, weight 68 ± 2 kg and mean age 27 ± 1 years were randomly assigned to 3 prescription groups: 30, 60 or 90 min/day PA. Results: Walking duration resulted in an almost linear increase in the number of steps per day during the prescription period from an average of about 10,000 steps per day for the 30-min prescription to about 14,000 for the 90-min prescription. Compliance was excellent for the 30-min prescription but decreased significantly with 60-min and 90-min prescriptions. In parallel, degree of compensation subsequent to exercise increased progressively as length of prescription increased. Conclusion: A 30-min prescription of extra walking 5 times per week was well tolerated. However, in order to increase total PA further, much more than 60 min of walking may need to be prescribed in the majority of individuals. While total exercise ‘volume' increased with prescriptions longer than 30 min, compliance to the prescription decreased and greater compensation was evident.

  14. Understanding community norms surrounding tobacco sales.

    Science.gov (United States)

    McDaniel, Patricia A; Malone, Ruth E

    2014-01-01

    In the US, denormalizing tobacco use is key to tobacco control; less attention has been paid to denormalizing tobacco sales. However, some localities have placed limits on the number and type of retailers who may sell tobacco, and some retailers have abandoned tobacco sales voluntarily. Understanding community norms surrounding tobacco sales may help accelerate tobacco denormalization. We conducted 15 focus groups with customers of California, New York, and Ohio retailers who had voluntarily discontinued tobacco sales to examine normative assumptions about where cigarettes should or should not be sold, voluntary decisions to discontinue tobacco sales, and government limits on such sales. Groups in all three states generally agreed that grocery stores that sold healthy products should not sell tobacco; California groups saw pharmacies similarly, while this was a minority opinion in the other two states. Convenience stores were regarded as a natural place to sell tobacco. In each state, it was regarded as normal and commendable for some stores to want to stop selling tobacco, although few participants could imagine convenience stores doing so. Views on government's role in setting limits on tobacco sales varied, with California and New York participants generally expressing support for restrictions, and Ohio participants expressing opposition. However, even those who expressed opposition did not approve of tobacco sales in all possible venues. Banning tobacco sales entirely was not yet normative. Limiting the ubiquitous availability of tobacco sales is key to ending the tobacco epidemic. Some limits on tobacco sales appear to be normative from the perspective of community members; it may be possible to shift norms further by problematizing the ubiquitous presence of cigarettes and drawing connections to other products already subject to restrictions.

  15. [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.

  16. 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)

  17. 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

  18. The power of r - pharmaceutical sales decomposition in Cyprus public healthcare sector and determinants of drug expenditure evolution: any lessons learned?

    Science.gov (United States)

    Petrou, Panagiotis

    2014-04-01

    The pharmaceutical sector has been established as the primary cost driver in health. The scope of this paper is to explore the drivers of pharmaceutical expenditure in Cyprus by decomposing sales and assessing impact of prices, volumes and substitution effect. We used a statistical approach to decompose the growth of public pharmaceutical expenditure during 2005-2011 into three elements: 1) substitution effect; 2) price effect; and 3) increase of consumption. We further decomposed consumption into: 1) prescription/visits; 2) visits/beneficiaries; and 3) beneficiaries. Pharmaceutical expenditure grew by 31.4 % and volume of medicines dispensed increased by 55%. Prices declined by 11% and product-mix residual was -5.5%, indicating that Cyprus experienced a switch to cheaper medicines (generics) without compromising access of patients to innovative medicines. This was enhanced by guidelines, monitoring of prescribing behavior, generic substitution and efficient tendering. The increasing number of products per prescriptions should be monitored with caution.

  19. 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...

  20. A pharmaco-epidemiological study of antibacterial treatments and bacterial diseases in Norwegian aquaculture from 2011 to 2016.

    Science.gov (United States)

    Lillehaug, Atle; Børnes, Christine; Grave, Kari

    2018-05-07

    The sales and prescription of antibacterials for use in Norwegian fish-farming according to diagnosis, fish species and production stage from 2011 to 2016 are analysed. The study is based on antibacterial sales data from wholesalers, pharmacies and feed mills and on prescription data obtained from a register of all prescriptions of antibacterials used in farmed fish. The results show that the fish-farming industry uses very small volumes of antibacterials. In 2016, a total of 212 kg were sold; the only antibacterial substances sold were florfenicol and oxolinic acid. The total amount corresponded to 0.16 mg kg-1 fish slaughtered, or to approximately 0.14% of the fish produced that year. The majority of prescriptions were for non-specific bacterial infections; as most common diseases are under control by vaccination. Most prescriptions for salmonid fish were during early production stages. However, due to higher biomasses of fish, the highest quantities of antibacterials were prescribed during the seawater production phase of Atlantic salmon Salmo salar. An increasing proportion of the prescriptions was for other species, including cleaner fish used for salmon lice control; in 2016 most prescriptions were for this fish category. Due to the negligible use of antibacterials in Norwegian aquaculture, in particular for on-growers, the risk of development of antimicrobial resistance and its transmission to humans through consumption of fish is considered negligible.

  1. 13 CFR 120.546 - Loan asset sales.

    Science.gov (United States)

    2010-01-01

    ... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Loan asset sales. 120.546 Section....546 Loan asset sales. (a) General. Loan asset sales are governed by § 120.545(b)(4) and by this... consented to SBA's sale of the loan (guaranteed and unguaranteed portions) in an asset sale conducted or...

  2. 18 CFR 292.305 - Rates for sales.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Rates for sales. 292... § 292.305 Rates for sales. (a) General rules. (1) Rates for sales: (i) Shall be just and reasonable and... to rates for sales to other customers served by the electric utility. (2) Rates for sales which are...

  3. 14 CFR 381.9 - Sales.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Sales. 381.9 Section 381.9 Aeronautics and... SPECIAL EVENT TOURS § 381.9 Sales. (a) Except as provided in paragraph (b) of this section: (1) No... booking must be returned within 3 business days. (2) Upon acceptance of the money for a sale, the operator...

  4. 48 CFR 245.7302 - Competitive sales.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Competitive sales. 245..., DEPARTMENT OF DEFENSE CONTRACT MANAGEMENT GOVERNMENT PROPERTY Sale of Surplus Contractor Inventory 245.7302 Competitive sales. ...

  5. Stagnant contraceptive sales after the Zika epidemic in Brazil.

    Science.gov (United States)

    Bahamondes, Luis; Ali, Moazzam; Monteiro, Ilza; Fernandes, Arlete

    2017-10-01

    Our aim was to assess national hormonal and non-hormonal contraceptive sales in Brazil after the Zika virus outbreak. Pharmaceutical companies based in Brazil provided data on monthly sales from September 2016 to June 2017. Data from both the public and private sectors were obtained about sales of registered, available modern contraceptive methods: combined oral contraceptive pill; progestin-only pill; vaginal and transdermal contraceptives; injectable contraceptives; long-acting reversible contraceptive (LARC) methods, including the copper-releasing intrauterine device, the levonorgestrel-releasing intrauterine system and the etonogestrel-releasing subdermal implant; and emergency contraceptive pills. Seventy-eight percent of sales comprised pills, patches and vaginal rings (11.1-13.8 million cycles/units per month), followed by emergency contraceptive pills (1.8-2.6 million pills), injectables (1.2-1.4 million ampoules) and LARC methods (6500-17,000 devices). The data showed much higher sales of short-acting methods compared with more effective LARC methods. The public sector needs to strengthen its focus on ensuring better access to LARC methods through a systematic approach ensuring regular supply, improved professional skills and better demand generation to couples wishing to avoid or delay pregnancy. In Zika virus-affected areas, many women of reproductive age may want to delay or postpone pregnancy by using an effective LARC method. The public sector should review its policies on LARC, as the need for these methods especially in Zika virus endemic areas may increase. A clear emphasis on quality in services, access and use is warranted.

  6. Estimating light-vehicle sales in Turkey

    Directory of Open Access Journals (Sweden)

    Ufuk Demiroğlu

    2016-09-01

    Full Text Available This paper is motivated by the surprising rapid growth of new light-vehicle sales in Turkey in 2015. Domestic sales grew 25%, dramatically surpassing the industry estimates of around 8%. Our approach is to inform the sales trend estimate with the information obtained from the light-vehicle stock (the number of cars and light trucks officially registered in the country, and the scrappage data. More specifically, we improve the sales trend estimate by estimating the trend of its stock. Using household data, we show that an important reason for the rapid sales growth is that an increasing share of household budgets is spent on automobile purchases. The elasticity of light-vehicle sales to cyclical changes in aggregate demand is high and robust; its estimates are around 6 with a standard deviation of about 0.5. The price elasticity of light-vehicle sales is estimated to be about 0.8, but the estimates are imprecise and not robust. We estimate the trend level of light-vehicle sales to be roughly 7 percent of the existing stock. A remarkable out-of-sample forecast performance is obtained for horizons up to nearly a decade by a regression equation using only a cyclical gap measure, the time trend and obvious policy dummies. Various specifications suggest that the strong 2015 growth of light-vehicle sales was predictable in late 2014.

  7. Analysis of Hypodermic Needles and Syringes for the Presence of Blood and Polydimethylsiloxane (Silicone) Utilizing Microchemical Tests and Infrared Spectroscopy.

    Science.gov (United States)

    Crowe, John B; Lanzarotta, Adam; Witkowski, Mark R; Andria, Sara E

    2015-07-01

    Suspect hypodermic needles and syringes were seized from an unlicensed individual who was allegedly injecting patients with silicone (polydimethylsiloxane [PDMS]) for cosmetic enhancement. Since control syringe barrels and needles often contain an interfering PDMS lubricant, a risk for false positives of foreign PDMS exists. The focus of this report was to minimize this risk and determine a quick and reliable test for the presence of blood in PDMS matrices. Using ATR-FT-IR spectroscopy, the risk for false-positive identification of foreign PDMS was reduced by (i) overfilling the sampling aperture to prevent spectral distortions and (ii) sampling a region of the suspect syringe/needle assembly where manufacturer-applied PDMS is not typically located. Analysis for blood indicated that the Teichman microchemical test was effective for detecting blood in the presence of PDMS. Overall, detecting PDMS established intent and detecting blood established that the needle containing the PDMS had been used for injection. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  8. [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.

  9. Understanding community norms surrounding tobacco sales.

    Directory of Open Access Journals (Sweden)

    Patricia A McDaniel

    Full Text Available In the US, denormalizing tobacco use is key to tobacco control; less attention has been paid to denormalizing tobacco sales. However, some localities have placed limits on the number and type of retailers who may sell tobacco, and some retailers have abandoned tobacco sales voluntarily. Understanding community norms surrounding tobacco sales may help accelerate tobacco denormalization.We conducted 15 focus groups with customers of California, New York, and Ohio retailers who had voluntarily discontinued tobacco sales to examine normative assumptions about where cigarettes should or should not be sold, voluntary decisions to discontinue tobacco sales, and government limits on such sales.Groups in all three states generally agreed that grocery stores that sold healthy products should not sell tobacco; California groups saw pharmacies similarly, while this was a minority opinion in the other two states. Convenience stores were regarded as a natural place to sell tobacco. In each state, it was regarded as normal and commendable for some stores to want to stop selling tobacco, although few participants could imagine convenience stores doing so. Views on government's role in setting limits on tobacco sales varied, with California and New York participants generally expressing support for restrictions, and Ohio participants expressing opposition. However, even those who expressed opposition did not approve of tobacco sales in all possible venues. Banning tobacco sales entirely was not yet normative.Limiting the ubiquitous availability of tobacco sales is key to ending the tobacco epidemic. Some limits on tobacco sales appear to be normative from the perspective of community members; it may be possible to shift norms further by problematizing the ubiquitous presence of cigarettes and drawing connections to other products already subject to restrictions.

  10. Fuel oil and kerosene sales 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-08-01

    The Fuel Oil and Kerosene Sales 1997 report provides information, illustrations and state-level statistical data on end-use sales of kerosene; No. 1, No. 2, and No. 4 distillate fuel oil; and residual fuel oil. State-level kerosene sales include volumes for residential, commercial, industrial, farm, and all other uses. State-level distillate sales include volumes for residential, commercial, industrial, oil company, railroad, vessel bunkering, military, electric utility, farm, on-highway, off highway construction, and other uses. State-level residual fuel sales include volumes for commercial, industrial, oil company, vessel bunkering, military, electric utility, and other uses. 24 tabs.

  11. Fuel oil and kerosene sales 1997

    International Nuclear Information System (INIS)

    1998-08-01

    The Fuel Oil and Kerosene Sales 1997 report provides information, illustrations and state-level statistical data on end-use sales of kerosene; No. 1, No. 2, and No. 4 distillate fuel oil; and residual fuel oil. State-level kerosene sales include volumes for residential, commercial, industrial, farm, and all other uses. State-level distillate sales include volumes for residential, commercial, industrial, oil company, railroad, vessel bunkering, military, electric utility, farm, on-highway, off highway construction, and other uses. State-level residual fuel sales include volumes for commercial, industrial, oil company, vessel bunkering, military, electric utility, and other uses. 24 tabs

  12. Organic Extractives from Mentha spp. Honey and the Bee-Stomach: Methyl Syringate, Vomifoliol, Terpenediol I, Hotrienol and Other Compounds

    Directory of Open Access Journals (Sweden)

    Igor Jerković

    2010-04-01

    Full Text Available The GC and GC/MS analyses of the solvent organic extractive from the stomach of the bees, having collected Mentha spp. nectar, revealed the presence of methyl syringate (6.6%, terpendiol I (5.0% and vomifoliol (3.0% that can be attributed to the plant origin. Other major compounds from the bee-stomach were related to the composition of cuticular waxes and less to pheromones. Organic extractivesfrom Mentha spp. honey were obtained by solvent-free headspace solid-phase microextraction (HS-SPME and ultrasonic solvent extraction (USE and analyzed by GC and GC/MS. The major honey headspace compounds were hotrienol (31.1%–38.5%, 2-methoxy-4-methylphenol (0.5–6.0%, cis- and trans-linalool oxides (0.9–2.8%, linalool (1.0–3.1% and neroloxide (0.9–1.9%. Methyl syringate was the most abundant compound (38.3-56.2% in the honey solvent extractives followed by vomifoliol (7.0–26.6%. Comparison of the honey organic extractives with the corresponding bee-stomach extractive indicated that methyl syringate and vomofoliol were transferred to the honey while terpendiol I was partially transformed to hotrienol in ripened honey.

  13. Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    R. Respaud

    2014-01-01

    Full Text Available Background. Ectopic pregnancy (EP is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX. Objective. The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP. Method. MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes. Results. We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made. Conclusion. The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays.

  14. Ethics, Justice and the Sale of Kidneys for Transplantation Purposes

    Directory of Open Access Journals (Sweden)

    M Slabbert

    2010-08-01

    Full Text Available Living kidney donor transplantations are complex; add to that financial compensation to the donor and one enters an ethical maze. Debates on whether the buying and selling of kidneys should be allowed are mainly between utilitarians, deontologists and virtue ethicists as legal transplants are more common in the Western world. The pros and cons of each theory in relation to the sale of human organs are analysed, after which the foundational principles for all bio-ethical judgments; beneficence, non-maleficence, autonomy and justice are also scrutinised in seeking to justify the sale of human kidneys for transplantation purposes in a country with a human rights culture.

  15. 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.

  16. Evaluation of site impacts associated with three silvicultural prescriptions in an upland hardwood stand in northern Alabama, USA

    Science.gov (United States)

    Emily A. Carter; Robert B. Rummer; Bryce J. Stokes

    2006-01-01

    Soil disturbance patterns and associated changes in soil physical status were measured in a study that evaluated the implementation of three alternative management prescriptions in an upland hardwood stand in northern Alabama, USA. Management prescriptions applied in this study consisted of a clear-cut, strip cut, and deferment cut that were compared to a non-harvested...

  17. Effect Of Sales Promotion On The Volume Of Sales Of Agroproduct ...

    African Journals Online (AJOL)

    The main objective of this study is to evaluate the effect of sales promotion on the volume of sales of Royco in Onitsha Urban city of Anambra State for the years 1998 and 1999. Data for the study was collected from 40 respondents (20 staff of UniLever Nig. Plc, producers of Royco and 20 Distributors of Royco) who were ...

  18. Merchandising of cigarettes in San Francisco pharmacies: 27 years later.

    Science.gov (United States)

    Eule, B; Sullivan, M K; Schroeder, S A; Hudmon, K S

    2004-12-01

    To estimate changes since 1976 in the proportion of San Francisco pharmacies that sell cigarettes and to characterise the advertising of cigarettes and the merchandising of non-prescription nicotine replacement therapy (NRT) products in these retail establishments. 100 randomly selected San Francisco pharmacies were visited in 2003. Pharmacies were characterised based on the sale of cigarettes, advertising for cigarettes, and the merchandising of non-prescription NRT products. In 2003, 61% of pharmacies sold cigarettes, a significant decrease compared to 89% of pharmacies selling cigarettes in 1976 (p merchandise the primary known risk factor for death in the USA.

  19. 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…

  20. 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.

  1. 26 CFR 1.338-4 - Aggregate deemed sale price; various aspects of taxation of the deemed asset sale.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 4 2010-04-01 2010-04-01 false Aggregate deemed sale price; various aspects of taxation of the deemed asset sale. 1.338-4 Section 1.338-4 Internal Revenue INTERNAL REVENUE SERVICE... Aggregate deemed sale price; various aspects of taxation of the deemed asset sale. (a) Scope. This section...

  2. 41 CFR 109-45.304-2.50 - Negotiated sales and negotiated sales at fixed prices by designated contractors.

    Science.gov (United States)

    2010-07-01

    ... suitable advertised sale; (2) Personal property is of such small value that the proceeds to be derived... fair market value of the personal property and other satisfactory terms of disposal are obtained by... PERSONAL PROPERTY 45.3-Sale of Personal Property § 109-45.304-2.50 Negotiated sales and negotiated sales at...

  3. Electric sales and revenue 1991

    International Nuclear Information System (INIS)

    1993-04-01

    The Electric Sales and Revenue is prepared by the Survey Management Division, Office of Coal, Nuclear, Electric and Alternate Fuels; Energy Information Administration (EIA); US Department of Energy. This publication provides information about sales of electricity, its associated revenue, and the average revenue per kilowatthour sold to residential, commercial, industrial, and other consumers throughout the United States. Previous publications presented data on typical electric bills at specified consumption levels as well as sales, revenue, and average revenue. The sales of electricity, associated revenue, and average revenue per kilowatthour provided in this report are presented at the national, Census division, State, and electric utility levels

  4. Terms of payment in the sales contract

    OpenAIRE

    Harmáčková, Iva

    2009-01-01

    This thesis makes an analysis of price and terms of payment in the sales contract. Both elements are conceived in terms of legal framework and in terms of importance for the parties to an international sales contract. The theoretical part deals with the role of the sales contract in business relations, structure and legal norms of the international sales contract. The practical part includes an analysis of specific international sales contract.

  5. Simultaneous extraction and determination of albendazole and triclabendazole by a novel syringe to syringe dispersive liquid phase microextraction-solidified floating organic drop combined with high performance liquid chromatography.

    Science.gov (United States)

    Asadi, Mohammad; Dadfarnia, Shayessteh; Haji Shabani, Ali Mohammad

    2016-08-17

    A syringe to syringe dispersive liquid phase microextraction-solidified floating organic drop was introduced and used for the simultaneous extraction of trace amounts of albendazole and triclabendazole from different matrices. The extracted analytes were determined by high performance liquid chromatography along with fluorescence detection. The analytical parameters affecting the microextraction efficiency including the nature and volume of the extraction solvent, sample volume, sample pH, ionic strength and the cycles of extraction were optimized. The calibration curves were linear in the range of 0.1-30.0 μg L(-1) and 0.2-30.0 μg L(-1) with determination coefficients of 0.9999 and 0.9998 for albendazole and triclabendazole respectively. The detection limits defined as three folds of the signal to noise ratio were found to be 0.02 μg L(-1) for albendazole and 0.06 μg L(-1) for triclabendazole. The inter-day and intra-day precision (RSD%) for both analytes at three concentration levels (0.5, 2.0 and 10.0 μg L(-1)) were in the range of 6.3-10.1% and 5.0-7.5% respectively. The developed method was successfully applied to determine albendazole and triclabendazole in water, cow milk, honey, and urine samples. Copyright © 2016. Published by Elsevier B.V.

  6. Structuring a Multiproduct Sales Quota-Bonus Plan for a Heterogeneous Sales Force: A Practical Model-Based Approach

    OpenAIRE

    Murali K. Mantrala; Prabhakant Sinha; Andris A. Zoltners

    1994-01-01

    This paper presents an agency theoretic model-based approach that assists sales managers in determining the profit-maximizing structure of a common multiproduct sales quota-bonus plan for a geographically specialized heterogeneous sales force operating in a repetitive buying environment. This approach involves estimating each salesperson's utility function for income and effort and using these models to predict individual sales achievements and the associated aggregate profit for the firm und...

  7. 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....

  8. Understanding Sex for Sale

    DEFF Research Database (Denmark)

    This book Understanding Sex for Sale: Meanings and Moralities of Sexual Commerce is dedicated to the exploration of the ways in which sex prostitution, sex work or sex for sale are taken for granted by particularly looking at how the relation between sex and money is interpreted and enacted....... This interdisciplinary book aims to understand how prostitution, sex work or sex for sale are defined, delineated, contested and understood in different places and times. The book offers contributions from a number of scholars who, based on their on their own research, discuss on going theoretical issues and analytical...... challenges Some chapters focuses on how prostitution, sex work or sex for sale have been regulated by the authorities and what understandings this regulation builds on. Other chapters investigate the experiences of the sex workers and sex buyers asking how these actors adjust to or resist the categorisation...

  9. 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.

  10. National All Schedules Prescription Electronic Reporting Act (NASPER): balancing substance abuse and medical necessity.

    Science.gov (United States)

    Manchikanti, Laxmaiah; Brown, Keith R; Singh, Vijay

    2002-07-01

    The National All Schedules Prescription Electronic Reporting Act, or NASPER, is a bill proposed by the American Society of Interventional Pain Physicians to provide and improve patient access with quality care, and protect patients and physicians from deleterious effects of controlled substance misuse, abuse and trafficking. Controlled prescription drugs, including narcotic analgesics, anxiolytics, anti-depressants, stimulants, and sedative-hypnotics play a significant and legitimate role in interventional pain management practices in managing chronic pain and related disorders. Based on the 1997 household survey on drug abuse it is estimated that 76.9 million Americans had used an illicit drug at least once in their life. In 1997, 4.2 million people used analgesics, 2.1 million used tranquillizers, and an additional 2.3 million people used various other drugs, including sedatives, tranquillizers, etc. The non-medical use of prescription drugs exceeds that of all illicit substances except for marijuana and hashish. The report on epidemiology trends in drug abuse, based on community epidemiology work group analysis showed continued increase of abuse of prescription drugs in urban, suburban, and rural areas. The most commonly abused drugs include oxycodone, hydrocodone, hydromorphone, morphine, codeine, clonazepam, alprazolam, lorazepam, diazepam and carisoprodol. The diversion of prescription controlled substances to illicit channels is a public health and safety issue. This review describes the role of controlled substances in chronic pain management, prevalence and economic impact of controlled substance abuse, prescription accountability, effectiveness of prescription monitoring programs, and rationale for national controlled substance electronic reporting system.

  11. 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

  12. The Role of Demographics as Predictors of Successful Performance of Sales Professionals in Business-to-Business Sales Organizations

    Science.gov (United States)

    Frino, Michael G.; Desiderio, Katie P.

    2013-01-01

    The purpose of this study was to examine the impact demographic variables of gender and sales experience have on the performance of business-to-business (B2B) sales professionals. If a deeper understanding can be established of how gender and sales experience variables relate to B2B sales performance, human resource development (HRD) and human…

  13. 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...

  14. 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...

  15. Antipsychotic Prescriptions for Children Aged 5 Years or Younger

    Directory of Open Access Journals (Sweden)

    Ana Lòpez-De Fede

    2014-10-01

    Full Text Available The use of antipsychotics in very young children is of concern given the lack of empirical evidence in their efficacy and long-term impact on children’s health. This study examined the prescription of antipsychotics among children aged ≤5 years enrolled in a state Medicaid program. Secondary data analysis was conducted using the Medicaid administrative data of a southeastern state. Using SAS 9.3, descriptive statistics were performed to examine socio-demographic characteristics, psychiatric diagnoses, off-label use, receipt of medications from multiple psychotropic drug classes, and receipt of non-pharmacologic psychiatric services among children aged ≤5 years who received antipsychotic prescriptions in calendar year (CY 2011. A total of 112 children in the target age group received antipsychotics in CY 2011, the most common prescription being risperidone. The most common listed psychiatric diagnosis was attention deficit hyperactivity disorder. Two in five children received antipsychotics for off-label use. Three in four children also received medications from at least one other psychotropic drug class. More than half did not receive adjunct psychiatric services. State-level policies offering specific guidance and recommendations for antipsychotic use among very young children are urgently needed. Future research is warranted to examine long-term impact of such practices on children’s growth and development.

  16. Improving sales management of agricultural enterprises

    Directory of Open Access Journals (Sweden)

    Balko S. V.

    2016-07-01

    Full Text Available the article discusses the effective sales of agricultural products. The authors recommend the directions of improving sales management system. Moreover, the research proves that sales and production activity should be based on complex analysis and monitoring of the market conditions.

  17. Lab-In-Syringe automation of stirring-assisted room-temperature headspace extraction coupled online to gas chromatography with flame ionization detection for determination of benzene, toluene, ethylbenzene, and xylenes in surface waters.

    Science.gov (United States)

    Horstkotte, Burkhard; Lopez de Los Mozos Atochero, Natalia; Solich, Petr

    2018-06-22

    Online coupling of Lab-In-Syringe automated headspace extraction to gas chromatography has been studied. The developed methodology was successfully applied to surface water analysis using benzene, toluene, ethylbenzene, and xylenes as model analytes. The extraction system consisted of an automatic syringe pump with a 5 mL syringe into which all solutions and air for headspace formation were aspirated. The syringe piston featured a longitudinal channel, which allowed connecting the syringe void directly to a gas chromatograph with flame ionization detector via a transfer capillary. Gas injection was achieved via opening a computer-controlled pinch valve and compressing the headspace, upon which separation was initialized. Extractions were performed at room temperature; yet sensitivity comparable to previous work was obtained by high headspace to sample ratio V HS /V Sample of 1.6:1 and injection of about 77% of the headspace. Assistance by in-syringe magnetic stirring yielded an about threefold increase in extraction efficiency. Interferences were compensated by using chlorobenzene as an internal standard. Syringe cleaning and extraction lasting over 10 min was carried out in parallel to the chromatographic run enabling a time of analysis of <19 min. Excellent peak area repeatabilities with RSD of <4% when omitting and <2% RSD when using internal standard corrections on 100 μg L -1 level were achieved. An average recovery of 97.7% and limit of detection of 1-2 μg L -1 were obtained in analyses of surface water. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. Inventories and sales uncertainty\\ud

    OpenAIRE

    Caglayan, M.; Maioli, S.; Mateut, S.

    2011-01-01

    We investigate the empirical linkages between sales uncertainty and firms´ inventory investment behavior while controlling for firms´ financial strength. Using large panels of manufacturing firms from several European countries we find that higher sales uncertainty leads to larger stocks of inventories. We also identify an indirect effect of sales uncertainty on inventory accumulation through the financial strength of firms. Our results provide evidence that financial strength mitigates the a...

  19. Mediating and Marketing Factors Influence the Prescription Behavior of Physicians: An Empirical Investigation

    Directory of Open Access Journals (Sweden)

    Rizwan Raheem Ahmed

    2016-02-01

    Full Text Available The authors present general review of the literature and the results of an empirical research on the subject. A cross-sectional questionnaire-based survey was conducted, being answered by 350 respondents: mix of graduate and post graduate doctors of private and public hospitals of Karachi City, and pharmaceutical personnel (mix of sales and marketing of national and multinational pharmaceutical companies operating in Pakistan. To test hypothesis, structural equation modelling (SEM was employed using AMOS 7 software package. As data are normally distributed, maximum likelihood method of estimation was used. Factorial ANOVA also enables us to examine the interaction effect between the factors. The results from factorial ANOVA test all the hypotheses of model, and results were declared significant at p <0.05. Findings are interesting as they establish association between variables (scientific literatures, promotional material, regular follow up, CMEs & conferences, personalized activities and prescription behavior of doctors mediated by strong phenomenon of medical representative PR and brand image of a company/product in changing the prescription behavior of doctors. Based on the results of this study, the pharmaceutical companies can device better marketing strategies keeping in view of these mediating effects. The article presents only two mediating and five marketing factors, whereas, more marketing and mediating variables can be added and tested, so, in future this gape can be overcome by other researchers. Moreover, a larger sample size could be applied and the scope of study can be enhanced.

  20. Marketing-sales interface and organizational competitiveness

    Directory of Open Access Journals (Sweden)

    George J. Avlonitis

    2015-03-01

    Full Text Available This paper focuses on the effectiveness of marketing-sales interfaces in B2B firms. As the body of knowledge on this domain is scarce, there is a greater need to investigate the specific aspects of marketing-sales configurations in such firms. The objective of this paper is to expand existing knowledge regarding marketing-sales interfaces in B2B firms, in order to identify the effectiveness of each configuration. Based on quantitative data collected from marketing or sales managers of 98 B2B firms, the study identifies the most effective marketing-sales interface in terms of smooth relationships and enhanced performance. The implications of the study are discussed.

  1. 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...

  2. 7 CFR 930.16 - Sales constituency.

    Science.gov (United States)

    2010-01-01

    ... Definitions § 930.16 Sales constituency. Sales constituency means a common marketing organization or brokerage... 7 Agriculture 8 2010-01-01 2010-01-01 false Sales constituency. 930.16 Section 930.16 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements...

  3. Merchandising at the point of sale: differential effect of end of aisle and islands

    Directory of Open Access Journals (Sweden)

    Álvaro Garrido-Morgado

    2015-01-01

    Full Text Available Merchandising at point of sale comprises a set of techniques aimed at encouraging the purchase at the point of sale. This paper analyzes the impact on sales of two of these techniques, especially used in the context of non-specialized food stores and rarely distinguished in academic research: (1 the presentation of product in the ends of the aisles or main aisles, leading from the side aisle access and, (2 the presentation of the product in islands within the main aisles. This research combines cross-sectional and longitudinal data and analyzes specific information on sales and commercial stimulus for all references in two large categories of products from a hypermarket over ten weeks. Results show that both the ends of aisle and the islands have a positive effect on sales and their relative importance depends on the nature of the category analyzed. There are also greater synergies between ends of aisle and price promotions. Finally, the results provide some evidence into the impact of the extension or termination of these merchandising stimuli.

  4. Consumer perceptions of the sale of tobacco products in pharmacies and grocery stores among U.S. adults.

    Science.gov (United States)

    Patwardhan, Pallavi; McMillen, Robert; Winickoff, Jonathan P

    2013-07-09

    Pharmacy-based tobacco sales are a rapidly increasing segment of the U.S. retail tobacco market. Growing evidence links easy access to tobacco retail outlets such as pharmacies to increased tobacco use. This mixed-mode survey was the first to employ a nationally representative sample of consumers (n = 3057) to explore their opinions on sale of tobacco products in pharmacies and grocery stores. The majority reported that sale of tobacco products should be either 'allowed if products hidden from view' (29.9%, 25.6%) or 'not allowed at all' (24.0%, 31.3%) in grocery stores and pharmacies, respectively. Significantly fewer smokers, compared to non-smokers, reported agreement on point-of-sale restrictions on sales of tobacco products (grocery stores: 27.1% vs. 59.6%, p sales of tobacco in grocery stores and pharmacies or allowing sales only if the products are hidden from direct view. Both policy changes would represent a departure from the status quo. Consistent with the views of practicing pharmacists and professional pharmacy organizations, consumers are also largely supportive of more restrictive policies.

  5. The smoking ban next door: do hospitality businesses in border areas have reduced sales after a statewide smoke-free policy?

    Science.gov (United States)

    Klein, Elizabeth G; Hood, Nancy E

    2015-01-01

    Despite numerous studies demonstrating no significant economic effects on hospitality businesses following a statewide smoke-free (SF) policy, regional concerns suggest that areas near states without SF policies may experience a loss of hospitality sales across the border. The present study evaluated the impact of Ohio's statewide SF policy on taxable restaurant and bar sales in border and non-border areas. Spline regression analysis was used to assess changes in monthly taxable sales at the county level in full-service restaurants and bars in Ohio. Data were analyzed from four years prior to policy implementation to three years post-policy. Change in the differences in the slope of taxable sales for border (n = 21) and non-border (n = 67) counties were evaluated for changes following the statewide SF policy enforcement, adjusted for unemployment rates, general trends in the hospitality sector, and seasonality. After adjusting for covariates, there was no statistically significant change in the difference in slope for taxable sales for either restaurants (β = 0.9, p = 0.09) or bars (β = 0.2, p = 0.07) following the SF policy for border areas compared to non-border areas of Ohio. Border regions in Ohio did not experience a significant change in bar and restaurant sales compared to non-border areas following a statewide SF policy. Results support that Ohio's statewide SF policy did not impact these two areas differently, and provide additional evidence for the continued use of SF policies to provide protection from exposure to secondhand smoke for both workers and the general public. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Particle creation and non-equilibrium thermodynamical prescription of dark fluids for universe bounded by an event horizon

    Science.gov (United States)

    Saha, Subhajit; Biswas, Atreyee; Chakraborty, Subenoy

    2015-03-01

    In the present work, flat FRW model of the universe is considered to be an isolated open thermodynamical system where non-equilibrium prescription has been studied using the mechanism of particle creation. In the perspective of recent observational evidences, the matter distribution in the universe is assumed to be dominated by dark matter and dark energy. The dark matter is chosen as dust while for dark energy, the following choices are considered: (i) Perfect fluid with constant equation of state and (ii) Holographic dark energy. In both the cases, the validity of generalized second law of thermodynamics (GSLT) which states that the total entropy of the fluid as well as that of the horizon should not decrease with the evolution of the universe, has been examined graphically for universe bounded by the event horizon. It is found that GSLT holds in both the cases with some restrictions on the interacting coupling parameter.

  7. Prematurity and prescription asthma medication from childhood to young adulthood

    DEFF Research Database (Denmark)

    Damgaard, Anne Louise; Hansen, Bo Moelholm; Mathiasen, Rene

    2015-01-01

    INTRODUCTION: Preterm birth is associated with increased risk of asthma-like symptoms and purchase of prescription asthma medication in childhood. We investigated whether this association persists into adulthood and whether it is affected by accounting for neonatal respiratory morbidity (acute...... both in childhood and adolescence. CONCLUSION: There was a strong dose-response association between gestational age and the purchase of prescription asthma medication in infancy and childhood. This association weakened during adolescence and was mostly non-significant in young adulthood. The increased...... respiratory disease and bronchopulmonary dysplasia). METHODS: A national cohort of all infants born in Denmark in the period 1980-2009 was included in this register study. Data on purchase of asthma medication (combination of inhaled β-2 agonists and other drugs for obstructive airway disease) in 2010...

  8. 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…

  9. Sales promotion strategies in Procter&Gamble

    OpenAIRE

    Šebesta, Miroslav

    2017-01-01

    The thesis gives comprehensive overview on the topic of sales promotions. The special focus is devoted to activities of Procter & Gamble on the Czech market. With increasing importance of sales promotions on the Czech market, the thesis aims to introduce main academic findings concerning sales promotions and test them on brands of Procter & Gamble. The next goal is to find out whether sales promotion strategies of Procter & Gamble provide a competitive advantage for the company on the Czech m...

  10. Social Networks and Sales Performance

    Directory of Open Access Journals (Sweden)

    Danny Pimentel Claro

    2011-05-01

    Full Text Available This paper argues that an informal network can itself be a basis for the increase in a sales manager’s performance. Informal networks create a structure that surpasses the formal hierarchical structure defined by the firm. We concentrated on the advice network and considered two different views of network structure that claim to have impact on performance. To explore this claim, we examined whether sales managers develop either a highly cohesive network structure (i.e. Coleman’s view or one containing structural holes (i.e. Burt’s view in order to achieve higher sales. We also investigated the matter of tie strength put forward by Granovetter in his seminal 1973 work. Census data was collected from about 500 personnel from an agricultural input retailer having 23 divisions. Estimates from a sample of 101 sales managers showed the importance of a highly cohesive structure (degree centrality for the three measures of sales manager’s performance. The strong ties have a positive impact on performance, suggesting the importance of building up strong bonds with network contacts. Sales managers’ age, time within the retailer and education also influence performance. These results imply that firms should stimulate contacts among personnel to spread technical and commercial information.

  11. Towards context aware food sales prediction

    NARCIS (Netherlands)

    Zliobaite, I.; Bakker, J.; Pechenizkiy, M.

    2009-01-01

    Sales prediction is a complex task because of a large number of factors affecting the demand. We present a context aware sales prediction approach, which selects the base predictor depending on the structural properties of the historical sales. In the experimental part we show that there exist

  12. 24 CFR 291.210 - Direct sales procedures.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Direct sales procedures. 291.210... URBAN DEVELOPMENT HUD-OWNED PROPERTIES DISPOSITION OF HUD-ACQUIRED SINGLE FAMILY PROPERTY Sales Procedures § 291.210 Direct sales procedures. When HUD conducts the sales listed in § 291.90(c), it will sell...

  13. Sharing and selling of prescription medications in a college student sample

    Science.gov (United States)

    Garnier, Laura M.; Arria, Amelia M.; Caldeira, Kimberly M.; Vincent, Kathryn B.; O’Grady, Kevin E.; Wish, Eric D.

    2009-01-01

    Objectives To estimate the prevalence of prescription medication diversion among college students; to compare classes of medications with respect to the likelihood of diversion; to document the most common methods of diversion; and to examine the characteristics of students who diverted medications. Method A cross-sectional analysis of personal interview data collected between August 2006 and August 2007 as part of an ongoing longitudinal study. The cohort of students, who were between the ages 17 and 19 at study onset, attended a large public university in the mid-Atlantic region. Information was gathered regarding a wide variety of variables, including demographics, diversion of medically prescribed drugs, illicit drug use, and childhood conduct problems. Results Among 483 students prescribed a medication, 35.8% diverted a medication at least once in their lifetime. The most commonly diverted medication classes were prescription ADHD medication, with a 61.7% diversion rate, and prescription analgesics (35.1% diversion rate). Sharing was the most common method of diversion, with 33.6% of students sharing their medication(s) and 9.3% selling in their lifetime. Comparative analyses revealed that prescription medication diverters had used more illicit drugs in the past year and had more childhood conduct problems than non-diverters. Conclusions If confirmed, these findings have important clinical implications for improved physician-patient communication and vigilance regarding prescribing analgesic and stimulant medications for young adults. PMID:20331930

  14. 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.

  15. 25 CFR 152.35 - Deferred payment sales.

    Science.gov (United States)

    2010-04-01

    ... desire, a sale may be made or approved on the deferred payment plan. The terms of the sale will be... 25 Indians 1 2010-04-01 2010-04-01 false Deferred payment sales. 152.35 Section 152.35 Indians..., CERTIFICATES OF COMPETENCY, REMOVAL OF RESTRICTIONS, AND SALE OF CERTAIN INDIAN LANDS Mortgages and Deeds of...

  16. 26 CFR 52.4682-2 - Qualifying sales.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 17 2010-04-01 2010-04-01 false Qualifying sales. 52.4682-2 Section 52.4682-2... TAXES (CONTINUED) ENVIRONMENTAL TAXES § 52.4682-2 Qualifying sales. (a) In general—(1) Special rules applicable to certain sales. Special rules apply to sales of ODCs in the following cases: (i) Under section...

  17. 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.

  18. 7 CFR 1955.148 - Auction sales.

    Science.gov (United States)

    2010-01-01

    ... complexity of the sale. When the services of a professional auctioneer are advisable, the services will be... 7 Agriculture 14 2010-01-01 2009-01-01 true Auction sales. 1955.148 Section 1955.148 Agriculture... REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Disposal of Inventory Property General § 1955.148 Auction sales...

  19. Motives for using: a comparison of prescription opioid, marijuana and cocaine dependent individuals.

    Science.gov (United States)

    Hartwell, Karen J; Back, Sudie E; McRae-Clark, Aimee L; Shaftman, Stephanie R; Brady, Kathleen T

    2012-04-01

    Identification of the motives for drug use is critical to the development of effective interventions. Furthermore, consideration of the differences in motives for drug use across substance dependent populations may assist in tailoring interventions. To date, few studies have systematically compared motives for substance use across drug classes. The current study examined motives for drug use between non-treatment seeking individuals with current prescription opioid, marijuana, or cocaine dependence. Participants (N=227) completed the Inventory of Drug-Taking Situations (IDTS; Annis, Turner & Sklar,1997), which contains eight subscales assessing motives for drug use. The findings revealed that prescription opioid dependent individuals scored significantly higher than all other groups on the Physical Discomfort, Testing Personal Control and Conflict with Others subscales. Both the prescription opioid and cocaine dependent groups scored significantly higher than the marijuana group on the Urges or a Temptation to Use subscale. In contrast, marijuana dependent individuals scored highest on the Pleasant Emotions and Pleasant Times with Others subscales. The marked differences revealed in motives for drug use could be used in the development and implementation of specific treatment interventions for prescription opioid, marijuana and cocaine dependent individuals. Published by Elsevier Ltd.

  20. Ending the war between Sales & Marketing.

    Science.gov (United States)

    Kotler, Philip; Rackham, Neil; Krishnaswamy, Suj

    2006-01-01

    Sales departments tend to believe that marketers are out of touch with what's really going on in the marketplace. Marketing people, in turn, believe the sales force is myopic--too focused on individual customer experiences, insufficiently aware of the larger market, and blind to the future. In short, each group undervalues the other's contributions. Both stumble (and organizational performance suffers) when they are out of sync. Yet few firms seem to make serious overtures toward analyzing and enhancing the relationship between these two critical functions. Curious about the misalignment between Sales and Marketing, the authors interviewed pairs of chief marketing officers and sales vice presidents to capture their perspectives. They looked in depth at the relationship between Sales and Marketing in a variety of companies in different industries. Their goal was to identify best practices that could enhance the joint performance and increase the contributions of these two functions. Among their findings: The marketing function takes different forms in different companies at different product life cycle stages. Marketing's increasing influence in each phase of an organization's growth profoundly affects its relationship with Sales. The strains between Sales and Marketing fall into two main categories: economic (a single budget is typically divided, between Sales and Marketing, and not always evenly) and cultural (the two functions attract very different types of people who achieve success by spending their time in very different ways). In this article, the authors describe the four types of relationships Sales and Marketing typically exhibit. They provide a diagnostic to help readers assess their companies' level of integration, and they offer recommendations for more closely aligning the two functions.

  1. Solution to Detect, Classify, and Report Illicit Online Marketing and Sales of Controlled Substances via Twitter: Using Machine Learning and Web Forensics to Combat Digital Opioid Access

    Science.gov (United States)

    Klugman, Josh; Kuzmenko, Ella; Gupta, Rashmi

    2018-01-01

    Background On December 6 and 7, 2017, the US Department of Health and Human Services (HHS) hosted its first Code-a-Thon event aimed at leveraging technology and data-driven solutions to help combat the opioid epidemic. The authors—an interdisciplinary team from academia, the private sector, and the US Centers for Disease Control and Prevention—participated in the Code-a-Thon as part of the prevention track. Objective The aim of this study was to develop and deploy a methodology using machine learning to accurately detect the marketing and sale of opioids by illicit online sellers via Twitter as part of participation at the HHS Opioid Code-a-Thon event. Methods Tweets were collected from the Twitter public application programming interface stream filtered for common prescription opioid keywords in conjunction with participation in the Code-a-Thon from November 15, 2017 to December 5, 2017. An unsupervised machine learning–based approach was developed and used during the Code-a-Thon competition (24 hours) to obtain a summary of the content of the tweets to isolate those clusters associated with illegal online marketing and sale using a biterm topic model (BTM). After isolating relevant tweets, hyperlinks associated with these tweets were reviewed to assess the characteristics of illegal online sellers. Results We collected and analyzed 213,041 tweets over the course of the Code-a-Thon containing keywords codeine, percocet, vicodin, oxycontin, oxycodone, fentanyl, and hydrocodone. Using BTM, 0.32% (692/213,041) tweets were identified as being associated with illegal online marketing and sale of prescription opioids. After removing duplicates and dead links, we identified 34 unique “live” tweets, with 44% (15/34) directing consumers to illicit online pharmacies, 32% (11/34) linked to individual drug sellers, and 21% (7/34) used by marketing affiliates. In addition to offering the “no prescription” sale of opioids, many of these vendors also sold other

  2. 36 CFR 223.32 - Timber sale operating plan.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Timber sale operating plan... SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER Timber Sale Contracts Contract Conditions and Provisions § 223.32 Timber sale operating plan. Sale contracts with a term of 2 years or more shall provide...

  3. A psychophysical account of patient non-adherence to medical prescriptions. The case of insulin dose adjustment.

    Science.gov (United States)

    Reach, G

    2013-02-01

    Diabetic patients often do not adjust their insulin doses using the algorithms that they have been taught. While this behavior may intuitively have a number of causes, such as the complexity of the decision or the fear of hypoglycaemia, we propose in this article a more general, "psychophysical", explanation based on behavioral economics concepts used to describe decisions made under uncertainty and risk. The concepts discussed herein may not be familiar to clinicians, who will find here an introduction to theories that may be helpful in understanding some aspects of non-adherence to medical prescriptions. 1) The Prospect Theory of Kahneman and Tversky proposes that choices made in the context of risk are subject to loss aversion. 2) Decisions under uncertainty use mental short cuts called "heuristics", which can lead to biases; for instance, overestimating the probability of the risk. 3) To understand the very concept of risk, emotions must be considered with a special focus on anticipated regret. 4) Finally, selection difficulty is an important determinant of the preference for the status quo. These concepts may be relevant for understanding a preference for the status quo in decisions made in a context of uncertainty and risk, such as insulin dose adjustment. We suggest that these mental mechanisms may also be involved in other aspects of patients' non-adherence. As other common human behaviors, non-adherence may actually often be a consequence of biases resulting from our ways of thinking, being both cognitive and emotional, and, according to Kahneman, more often "fast" than "slow". Empirical studies are needed to support this hypothesis. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  4. Schedule Sales Query Raw Data

    Data.gov (United States)

    General Services Administration — Schedule Sales Query presents sales volume figures as reported to GSA by contractors. The reports are generated as quarterly reports for the current year and the...

  5. Reações locais e níveis de antitoxina circulante decorrentes de administração do toxóide tetânico: estudo comparativo entre Ped-o-Jet e seringa hipodérmica Local reactions and antitoxin levels induced by the administration of tetanus toxoid: a comparative study between Ped-o-Jet and hypodermic syringe

    Directory of Open Access Journals (Sweden)

    Ana Maria Aratangy Pluciennik

    1985-06-01

    Full Text Available Com o objetivo de comparar reações locais e conversão sorológica apresentadas por adultos que receberam o toxóide tetânico através de Ped-o-Jet (via subcutânea ou de seringa hipodérmica (via intramuscular, o toxóide foi administrado a 472 recrutas do Exército. Em observações realizadas 4 e 24 horas após a vacinação verificou-se que as reações locais dos indivíduos vacinados com Ped-o-Jet eram significativamente mais freqüentes e mais intensas do que aquelas dos vacinados com seringa hipodérmica, não tendo ocorrido, entretanto, reações graves. A conversão sorológica dos não imunes vacinados com Ped-o-Jet ocorreu numa freqüência maior do que nos indivíduos vacinados com seringa hipodérmica. Conclui-se portanto, que o Ped-o-Jet pode ser utilizado em campanhas de vacinação em massa contra o tétano, embora a via de administração preferencial, até o momento, seja a intramuscular.This paper deals with the administration of tetanus toxoid to 472 army recruits, 50% of which received the vaccine subcutaneously using a Ped-o-Jet pressure injector and the remaining subjects received the vaccine intramuscularly, with hypodermic syringe and needle. The objective was to draw comparative conclusions regarding local reactions and serumconvertion in those young adults. Local reactions were observed four and 24 hours after immunization. Although significantly more frequent and intense in individuals receiving the toxoid by jet injection than in those inoculated with hypodermic syringe, no serious reactions were registered. At the first observation, local reactions occured in 64% of black men vaccinated by Ped-o-Jet and in only 31% of those vaccinated by syringe; 70% of the non-black showed local reactions when vaccinated by Ped-o-Jet and 21% when vaccinated by hypodermic syringe. At the second observation, black men vaccinated by Ped-o-Jet showed local reactions in 78% of the cases and in 3% when vaccinated by syringe; 87% of

  6. 7 CFR 929.13 - Sales history.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Sales history. 929.13 Section 929.13 Agriculture... LONG ISLAND IN THE STATE OF NEW YORK Order Regulating Handling Definitions § 929.13 Sales history. Sales history means the number of barrels of cranberries established for a grower by the committee...

  7. 36 CFR 223.227 - Sale advertisement.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 2 2010-07-01 2010-07-01 false Sale advertisement. 223.227... DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER Special Forest Products Advertisement and Bids § 223.227 Sale advertisement. (a) The Forest Service shall advertise any special forest products sales with an appraised value...

  8. 7 CFR 929.149 - Determination of sales history.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Determination of sales history. 929.149 Section 929... Determination of sales history. A sales history for each grower shall be computed by the Committee in the following manner. (a) For each grower with acreage with 7 or more years of sales history, a new sales...

  9. The sale of alcohol in Denmark

    DEFF Research Database (Denmark)

    laCour, Lisbeth; Milhøj, Anders

    2009-01-01

    How do prices affect the choice of types of alcohol in Denmark? We study the Danish sale of alcoholic beverages in a time series framework. First, we look at annual data from 1980 investigating the hypothesis of a fairly stable level of sales. We conclude stationarity of sales and we also find...

  10. 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.

  11. 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

  12. Student Guide for Documenting Experiential Learning: Sales and Marketing Management.

    Science.gov (United States)

    Coastline Community Coll., Fountain Valley, CA.

    Coastline Community College has developed a series of guides to assist adults who wish to obtain college credit or advanced standing in evaluating and verifying their non-college learning experiences. This guide lists the competency requirements of six courses in the Sales and Marketing Management program: Principles of Accounting, Salesmanship,…

  13. Sales Rebate Contracts in Fashion Supply Chains

    Directory of Open Access Journals (Sweden)

    Chun-Hung Chiu

    2012-01-01

    Full Text Available We explore in this paper the performance of sales rebate contracts in fashion supply chains. We conduct both analytical and numerical analyses via a mean-variance framework with reference to real empirical data. To be specific, we evaluate the expected profits and variance of profits (risk of the fashion supply chains, fashion retailers, and manufacturers under (1 the currently implemented sales rebate practices, (2 the case without sales rebate, and (3 the theoretical coordination situation (if target sales rebate is adopted. In addition, we analyze how sales effort affects the performances of the supply chain and its agents. Our analysis indicates that the rebate contracts may hurt the retailer and the manufacturer of a fashion supply chain when it is inappropriately set. Moreover, a properly designed sales rebate contract not only can coordinate the supply chain (with retail sales effort but can also improve expected profits and lower the levels of risk for both the manufacturer and the retailer.

  14. 7 CFR 929.48 - Sales history.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 8 2010-01-01 2010-01-01 false Sales history. 929.48 Section 929.48 Agriculture... LONG ISLAND IN THE STATE OF NEW YORK Order Regulating Handling Regulations § 929.48 Sales history. (a) A sales history for each grower shall be computed by the committee in the following manner: (1) For...

  15. 14 CFR 212.7 - Direct sales.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Direct sales. 212.7 Section 212.7... REGULATIONS CHARTER RULES FOR U.S. AND FOREIGN DIRECT AIR CARRIERS § 212.7 Direct sales. (a) Certificated and foreign air carriers may sell or offer for sale, and operate, as principal, Public Charter flights under...

  16. 27 CFR 6.71 - Quota sales.

    Science.gov (United States)

    2010-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Quota sales. 6.71 Section 6.71 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS âTIED-HOUSEâ Unlawful Inducements Quota Sales § 6.71 Quota sales. The act by an...

  17. Third quarter 2005 sales figures

    International Nuclear Information System (INIS)

    2005-01-01

    With manufacturing facilities in over 40 countries and a sales network in over 100, AREVA offers customers technological solutions for nuclear power generation and electricity transmission and distribution. The group also provides interconnect systems to the telecommunications, computer and automotive markets. This document presents the sales figures of the group for the third quarter of 2005: sales revenues in the front end division, in the reactor and services division, in the back end division and in the transmission and distribution division

  18. Common state mechanisms regulating tribal tobacco taxation and sales, the USA, 2015.

    Science.gov (United States)

    DeLong, Hillary; Chriqui, Jamie; Leider, Julien; Chaloupka, Frank J

    2016-10-01

    Native American tribes, as sovereign nations, are exempt from state tobacco excise taxation, and self-govern on-reservation activity in the USA. Under Federal law, state excise taxes are owed by non-members purchasing tobacco on tribal land, but states are limited in how they enforce or collect these taxes. This study highlights the various policy approaches that states have taken to regulate tobacco sales on tribal lands given jurisdictional challenges. State laws (statutes, regulations and case law), Attorney General opinions, and revenue notices and rulings effective as of 1 January 2015 for all 50 states and the District of Columbia were compiled using Boolean searches in Lexis-Nexis and Westlaw. Laws were limited to those addressing taxation compacts or tobacco sales involving tribal entities. Master Settlement Agreement laws and non-codified tribal codes/compacts were excluded. Twenty of the 34 states with tribal lands address tribal tobacco sales. Fourteen states address intergovernmental compacts: 11 are tobacco specific, and suggest or require specific provisions. Fifteen states address tribal tax stamps: 2 explicitly prohibit stamping tribally sold products, 9 stamp all products, and 4 stamp some. Prepayment of excise tax is required in 12 states: 6 on all products, 4 on products in excess of quota, and 2 on products sold by non-tribal retailers. 6 states use quotas to limit tax-free tobacco available to tribes. Many states with a tribal presence have no formal strategies for non-members purchasing tobacco on tribal lands. Formalising policies and harmonising tax rates may assist states in collecting tax revenue from non-tribal consumers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. 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.

  20. The new science of sales force productivity.

    Science.gov (United States)

    Ledingham, Dianne; Kovac, Mark; Simon, Heidi Locke

    2006-09-01

    For years, sales managers at many companies have relied on top performers and sheer numbers of sales reps to stay competitive. But while they may have squeaked by on this wing-and-a-prayer technique, their sales teams haven't thrived the way they once did. Today's most successful sales leaders are taking a more scientific approach. Savvy managers are reshaping their tactics in response to changing markets. They are reaching out to new customers in innovative ways. And they are increasing productivity by helping the reps they already have make the most of their skills and resources. Leaders who take a scientific approach to sales force effectiveness have learned to use four levers to boost their reps' productivity in a predictable and manageable way. First, they systematically target their firms' offerings, matching the right products with the right customers. Second, they optimize the automation, tools, and procedures at their disposal, providing reps with the support they need to boost sales.Third, they analyze and manage their reps' performance, measuring both internal processes and results to determine where their teams' strengths and weaknesses are. Fourth, they pay close attention to sales force deployment--how well sales, support, marketing, and delivery resources are matched to customers. These four levers can help sales leaders increase productivity across the board, the authors say, though they have the greatest impact on lower-ranked performers. The overall effect of increasing the average sales per employee can be exponential; it means a company won't have to rely on just a few talented individuals to stay competitive. This is especially important because finding and keeping star salespeople is more difficult than ever. What's more, managers who optimize the sales forces they already have can see returns they never thought possible.