Patanwala A.E.,University of Arizona |
Sanders A.B.,University of Arizona |
Thomas M.C.,South University |
Acquisto N.M.,University of Rochester |
And 3 more authors.
Annals of Emergency Medicine | Year: 2012
Study objective: The primary objective of this study is to determine the activities of pharmacists that lead to medication error interception in the emergency department (ED). Methods: This was a prospective, multicenter cohort study conducted in 4 geographically diverse academic and community EDs in the United States. Each site had clinical pharmacy services. Pharmacists at each site recorded their medication error interceptions for 250 hours of cumulative time when present in the ED (1,000 hours total for all 4 sites). Items recorded included the activities of the pharmacist that led to medication error interception, type of orders, phase of medication use process, and type of error. Independent evaluators reviewed all medication errors. Descriptive analyses were performed for all variables. Results: A total of 16,446 patients presented to the EDs during the study, resulting in 364 confirmed medication error interceptions by pharmacists. The pharmacists' activities that led to medication error interception were as follows: involvement in consultative activities (n=187; 51.4%), review of medication orders (n=127; 34.9%), and other (n=50; 13.7%). The types of orders resulting in medication error interceptions were written or computerized orders (n=198; 54.4%), verbal orders (n=119; 32.7%), and other (n=47; 12.9%). Most medication error interceptions occurred during the prescribing phase of the medication use process (n=300; 82.4%) and the most common type of error was wrong dose (n=161; 44.2%). Conclusion: Pharmacists' review of written or computerized medication orders accounts for only a third of medication error interceptions. Most medication error interceptions occur during consultative activities. © 2011 American College of Emergency Physicians.
Jain P.K.,University of Missouri - Kansas City |
Shah S.,South University |
Friedman S.H.,University of Missouri - Kansas City
Journal of the American Chemical Society | Year: 2011
The spacing, timing, and amount of gene expression are crucial for a range of biological processes, including development. For this reason, there have been many attempts to bring gene expression under the control of light. We have previously shown that RNA interference (RNAi) can be controlled with light through the use of siRNA and dsRNA that have their terminal phosphates modified with the dimethoxy nitro phenyl ethyl (DMNPE) group. Upon irradiation, these groups photolyze and release native RNA. The main problem with light activated RNA interference (LARI) to date is that the groups used only partially block RNA interference prior to irradiation, thus limiting the utility of the approach. Here, we describe a new photocleavable group, cyclo-dodecyl DMNPE (CD-DMNPE), designed to completely block the interaction of duplexes with the cellular machinery responsible for RNA interference prior to irradiation. This allowed us to switch from normal to a near complete reduction in gene expression using light, and to construct well-defined patterns of gene expression in cell monolayers. Because this approach is built on the RNA interference pathway, it benefits from the ability to quickly identify duplexes that are effective at low or subnanomolar concentrations. In addition, it allows for the targeting of endogenous genes without additional genetic manipulation. Finally, because of the regiospecificity of CD-DMNPE, it allows a standard duplex to be quickly modified in a single step. The combination of its efficacy and ease of application will allow for the facile control of the spacing, timing, and degree of gene expression in a range of biological systems. © 2011 American Chemical Society.
Maxwell C.B.,Jackson Madison County General Hospital |
Crouch M.A.,South University
American Journal of Health-System Pharmacy | Year: 2010
Purpose. The use of intrapericardial triamcinolone for acute pericarditis after electro-physiologic procedures in three patients is described. Summary. Treatment for idiopathic pericarditis and viral pericarditis, which account for about 85% of cases, focuses on pain management and decreasing pericardial inflammation. This is oftentimes achieved with nonsteroidal antiinflammatory drugs (NSAIDs). Colchicine may be used in combination with NSAIDs, specifically in postmyocardial infarction pericarditis and recurrent pericarditis. Because oral corticosteroid use has been shown to be an independent risk factor in pericarditis recurrence, their use in patients with refractory pericarditis is reserved as a last-resort option. Intrapericardial triamcinolone is an uncommon treatment approach, although it is recommended in select situations of pericarditis according to guidelines developed by the European Society of Cardiology. In this retrospective case series, three patients with pericarditis, tamponade, or both as a complication of radiofrequency ablation or implantable cardioverter defibrillator implantation received triamcinolone. The drug was instilled intrapericardially, with doses ranging from 50 to 200 mg. In two patients, the need for pain medication and the perceived pain score decreased dramatically after triamcinolone administration. In the third patient, triamcinolone administration decreased the need for supportive therapy but was not deemed a complete clinical success. Additional study is necessary to better define the use of intrapericardial triamcinolone and determine long-term outcomes associated with this therapy. Other factors, including past medical history and renal function, also need to be taken into account when choosing the proper dosing regimen. Conclusion. Intrapericardial administration of triamcinolone acetonide may be an effective treatment for patients with acute pericarditis after electrophysiologic procedures. Copyright © 2010, American Society of Health-System Pharmacists, Inc. All rights reserved.
Lewis K.M.,Virginia Polytechnic Institute and State University |
Byrd D.A.,South University |
Ollendick T.H.,Virginia Polytechnic Institute and State University
Journal of Anxiety Disorders | Year: 2012
The purpose of the present study was to determine the relations among negative life events, social support, coping and anxiety symptoms in 709 Caucasian and African-American youth between 11 and 14 years of age. Results indicated that more negative life events, less social support, more coping efforts, and African-American status were related to more anxiety symptoms. Additionally, although active coping moderated the relationship between negative life events and anxiety, these relations were qualified in separate analyses for the African-American and Caucasian youth. Negative life events were related to anxiety symptoms only for the African-American participants. When these findings were explored further for males and females of each racial group, negative life events remained significant for African-American males but not African-American females. Implications of these findings are examined and future directions for research to understand the processes underlying these relations with both Caucasian and African-American youth are addressed. © 2011 Elsevier Ltd.
Blissit K.T.,William Jennings Bryan Dorn Veterans Affairs Medical Center |
Tillery E.,South University |
Latham C.,Pharmacy Services |
Pacheco-Perez J.,G Werber Bryan Psychiatric Hospitalbc
American Journal of Health-System Pharmacy | Year: 2014
Purpose: Four cases in which glycopyrrolate was used to treat clozapine-induced sialorrhea (CIS) are reported.Summary: Glycopyrrolate is an antimuscarinic agent that can be used preoperatively to inhibit drooling and excessive secretions of the respiratory tract. The outcomes of four patients who received glycopyrrolate for the treatment of CIS are described. The Thomas-Stonell and Greenberg Drooling Severity and Frequency Scale (DSFS) was used retrospectively to rate patients' drooling. Glycopyrrolate was effective in alleviating CIS in cases 1-3. Two patients (cases 1 and 4) exhibited severe drooling, which caused their clothing, hands, and objects to consistently become wet. One patient (case 1) responded well to glycopyrrolate and was restarted on the medication when CIS returned after discontinuation of the drug. While another patient (case 3) displayed a similar response to therapy for CIS as the patient described in case 1, this patient did not experience the psychosocial complications as did the patient in case 1, possibly due to the use of glycopyrrolate as the initial treatment of choice. The patient in case 2 experienced moderate but frequent drooling. Thioridazine's high anticholinergic potential may have contributed to this patient's lower baseline DSFS score compared with the scores of the other three patients, or it could have augmented initial symptom improvement. CIS continued in the patient described in case 4 despite treatment with glycopyrrolate, with only mild improvement in the severity and frequency of drooling.Conclusion: Glycopyrrolate was effective in alleviating symptoms in three of four patients with CIS. In a fourth patient, the degree of improvement was unknown due to documentation discrepancies; however, mild improvement was noted initially. © 2014, American Society of Health-System Pharmacists, Inc.
Thomas M.C.,South University |
Thomas M.C.,Western New England University |
Macias-Moriarity L.Z.,South University
American Journal of Pharmaceutical Education | Year: 2014
Objective. To measure changes in students' knowledge and confidence scores after completing an elective clinical toxicology course in an accelerated doctor of pharmacy (PharmD) program. Design. Various active-learning techniques were used to create a learner-centered environment. Approximately two-thirds of the course used student-led presentations. Some of those not presenting were assigned to be evaluators, responsible for asking the presenter a question or writing quiz questions based on the presented material. Other learner-centered activities included weekly quizzes and discussions at the conclusion of each presented topic. Assessment. A test instrument designed tomeasure students' knowledge and associated level of confidence on each item was administered at the beginning and end of the course. Students' knowledge and confidence scores increased significantly from pretest to posttest. Conclusions. Students' increased confidence and knowledge scores were well correlated after course completion, indicating students were better able to self-assess these areas. These findings suggest that confidence could be an additional measure of students' metacognitive skill development.
Schweiger T.A.,Lake Erie College |
Zdanowicz M.,South University
American Journal of Health-System Pharmacy | Year: 2010
Purpose. The literature was reviewed to determine whether data support current treatment guideline recommendations regarding the use of systemic corticosteroids in the treatment of chronic obstructive pulmonary disease (COPD) exacerbations. Summary. Exacerbations of COPD are common and can be detrimental to both patient health and health care costs. Corticosteroids are recommended by consensus guidelines for patients during exacerbations of COPD. Although guidelines make very specific recommendations, clinical data are conflicting and inconsistent. A search of the English-language medical literature was performed, and all randomized, double-blind, placebo-controlled trials or meta-analyses that examined the use of systemic corticosteroids in COPD exacerbations were included. Trials that included nebulized corticosteroids were also included as long as they were compared to a systemic corticosteroid and a placebo. Recommendations regarding the use of systemic corticosteroids are not optimal or completely supported. Data support recommendations if patients are treated on an outpatient basis. However, hospitalized patients might also benefit from higher doses of systemic steroids initially, followed by an oral taper dose. Conclusion. In the treatment of COPD exacerbations, systemic corticosteroids improve airflow limitations, decrease treatment failure rates, decrease the risk of relapse, and may improve symptoms and decrease the length of hospital stay. Because of the risks of adverse effects, the lowest dose and shortest duration of corticosteroid therapy that will provide therapeutic benefit should be chosen. The literature suggests that hospitalized patients should benefit from a higher initial dosage of systemic corticosteroids than the 30-40 mg of i.v. or oral prednisolone for 7-10 days recommended in current guidelines. Copyright © 2010, American Society of Health-System Pharmacists, Inc. All rights reserved.
Pritham U.A.,Georgia Southern University |
Mckay L.,South University
JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing | Year: 2014
Safe and effective management of chronic pain in pregnancy is challenging. Use of over-the-counter analgesics, opioids, opioid substitution therapies, complementary and alternative therapies, antidepressants, and anxiolytics each have benefits and risks for the mother and neonate that must be considered. Because of their potency, opioids are often used despite associated risks for adverse effects, abuse, diversion, and addiction. Development of a pain management protocol for the counsel and care of pregnant women with pain is necessary. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.
News Article | December 5, 2016
With an upcoming publication in the Worldwide Leaders in Healthcare, Onyl Channer, RN, BSN, joins the prestigious ranks of the International Nurses Association. Onyl is a Registered Nurse with 18 years of experience and an extensive expertise in all facets of nursing, especially in the program all-inclusive care of the elderly, both in home and facility based, primary care management, dialysis, and oncology nursing. Onyl is currently serving patients at CenterLight Healthcare PACE, and is also affiliated with St. Barnabas Hospital and the Einstein/Montefiore Medical Center. Onyl Channer received her Licensed Practical Nurse Degree in 1998, before going on to obtain her Nursing Degree from Bronx Community College in 2004. An advocate for continuing education, Onyl then graduated with her Bachelor of Science Degree in Nursing in 2011 from the College of New Rochelle, followed by her Master Degree in Administration in 2015 from South University. Furthermore, she holds additional certification as a Certified Case Manager, Certified Dialysis Nurse, and a Certified Wound Care Nurse. To keep up to date with the latest advances and developments in the nursing field, Onyl maintains a professional membership with the American Nurses Association, the Student Conservation Association, and Sigma Theta Tau. For her excellence, Onyl was awarded 1st Class Honors in Jamaica, as well as Fellowship Awards. She attributes her great success to her strong faith, as well as the support from her family, friends and coworkers. She has always been encouraged to do more and learn more, and truly wants to give back. Onyl is also committed to making sure young nurses have a solid foundation to build from, and that as nurses they stay patient focused. When she is not assisting her patients, Onyl dedicates her free time to community and church work, and spending time with her family. Learn more about Onyl Channer here: http://inanurse.org/network/index.php?do=/4128716/info/ and be sure to read her upcoming publication in the Worldwide Leaders in Healthcare.
News Article | April 28, 2016
Last year while checking out coral reefs and sharks in the Solomon Islands, marine biologist David Gruber stumbled upon something bizarre: a “glowing” sea turtle. Turns out it wasn’t a nuclear experiment gone awry, but rather one of hundreds of fluorescent marine species that Gruber has discovered in recent years. It’s not as if we didn’t know that many of these species existed, but rather just that we didn’t know they were fluorescent because the characteristic isn’t visible to the naked human eye. Sometimes confused with bioluminescence, fluorescence is when an animal absorbs light and then emits it at a lower energy level, causing the light to be a different color. In order to capture the turtle emitting glowing light, Gruber and his team used blue lights and a camera with yellow filters capable of capturing the turtle’s luminosity. While taking pictures of luminescent fish can make for some awesome shots, scientists generally have no idea why so many species exhibit the characteristic. Some studies show that fish may use it to signal one another or for camouflage, but no one knows for sure. The fact that so many different species evolved to have the characteristic indicate that it must be used for something, but it’s still a mystery. Gruber and his team think that they now might have uncovered some answers. In a new video from National Geographic, Gruber shows off a “shark-eye” camera that he built in order to simulate the ways in which two luminescent sharks, swell sharks, and chain catsharks see each other in the depths of the ocean. In their model, the researchers found that when the sharks swim deeper into the dark ocean, the fluorescence of other sharks’ does seem to stand out. This indicates that maybe the trait helps them find one another. As The Atlantic reported though, not all scientists are convinced by Gruber’s findings. Two other researchers, Nathan Hart, a biologist at Macquarie University in New South Wales and Christine Bedore, of Georgia South University, both doubted whether the study really uncovered the mystery behind bioluminescence. Gruber stressed that these findings are only the first step, and that there’s still a lot to be learned. For now, we just don’t know for sure why so much of the ocean is glowing.