Traditionally, physicians recruited clinical trial subjects, but pharmaceutical companies have become ever more involved through centralized campaigns. Physicians are vital to a trial and the pharmaceutical effort helps shift some of the recruitment demands away from the site to allow them to focus on the subjects. Thus, it is practical to understand if different recruitment methods could change or skew the study population. This study determines if differences or similarities occurred between subjects recruited by physicians and pharmaceutical companies. It discovered that some of both occurred. The pharmaceutical company efforts helped recruit potential subjects from the general population that were similar to subjects recruited by the physicians, but this particular campaign was limited by language which affected recruitment of Hispanic subjects. The social impact of this study provides insight about pharmaceutical company recruitment. Since the National Library of Medicine has indicated that clinical trials should reflect the broader diseased population, the efforts of the pharmaceutical company can help support the physicians’ efforts by recruiting from the broader population. Together, both efforts can create a global good by allowing the trial to reflect the population of post-approval use. These findings still raise a question about the proper balance between the two recruitment groups so that the intended characteristics of the diseased population are maintained. Because differences between physician and pharmaceutical recruited subjects can exist, the potential of one group to bias the trial results exist. As such, some analysis by recruitment method can help ensure that variations in the study population are minimal without skewing the data to create positive study results.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Study of medication appropriateness during hospital stay and revisits in medi...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
OMICS Publishing Group, Journal of Clinical Pharmacology & Biopharmaceutics (CPB) emphasizes the phases of drug development from absorption, disposition, metabolism, excretion interactions and rational design of drug products to deliver the drug at a specific rate to the body in order to optimize the therapeutic effect and minimize any adverse effects. The CPB acts as an interface between academics, those in research and developments, explicates the research on various developmental applications for contemporary drug development and utilization.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
Study of medication appropriateness during hospital stay and revisits in medi...iosrjce
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
OMICS Publishing Group, Journal of Clinical Pharmacology & Biopharmaceutics (CPB) emphasizes the phases of drug development from absorption, disposition, metabolism, excretion interactions and rational design of drug products to deliver the drug at a specific rate to the body in order to optimize the therapeutic effect and minimize any adverse effects. The CPB acts as an interface between academics, those in research and developments, explicates the research on various developmental applications for contemporary drug development and utilization.
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
Overall patient satisfaction was significantly higher in homeopathic than in ...home
The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in
relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS
due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias
in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted
Part of the MaRS BioEntrepreneurship series session: Clinical Trials Strategy
Speaker: Miklos Schulz
This is available as an audio presentation:
http://www.marsdd.com/bioent/feb12
Also view the event blog and summary:
http://blog.marsdd.com/2007/02/14/bioentrepreneurship-clinical-trial-strategies-its-never-too-soon/
A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADH...Aji Wibowo
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence selfreported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1-6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.
Medical Conferences, Pharma Conferences, Engineering Conferences, Science Conferences, Manufacturing Conferences, Social Science Conferences, Business Conferences, Scientific Conferences Malaysia, Thailand, Singapore, Hong Kong, Dubai, Turkey 2014 2015 2016
Global Research & Development Services (GRDS) is a leading academic event organizer, publishing Open Access Journals and conducting several professionally organized international conferences all over the globe annually. GRDS aims to disseminate knowledge and innovation with the help of its International Conferences and open access publications. GRDS International conferences are world-class events which provide a meaningful platform for researchers, students, academicians, institutions, entrepreneurs, industries and practitioners to create, share and disseminate knowledge and innovation and to develop long-lasting network and collaboration.
GRDS is a blend of Open Access Publications and world-wide International Conferences and Academic events. The prime mission of GRDS is to make continuous efforts in transforming the lives of people around the world through education, application of research and innovative ideas.
Global Research & Development Services (GRDS) is also active in the field of Research Funding, Research Consultancy, Training and Workshops along with International Conferences and Open Access Publications.
International Conferences 2014 – 2015
Malaysia Conferences, Thailand Conferences, Singapore Conferences, Hong Kong Conferences, Dubai Conferences, Turkey Conferences, Conference Listing, Conference Alerts
Comparative evaluation of 2g single dose versus conventional dose azithromycin in uncomplicated skin and skin structure infections. Indian Journal Of Pharmacology. August 2015;Vol. 47; Issue 4
Overall patient satisfaction was significantly higher in homeopathic than in ...home
The results of our systematic review provide limited evidence for the effectiveness of CAM therapy in
relieving symptoms of CFS. However, we are not able to draw firm conclusions concerning CAM therapy for CFS
due to the limited number of RCTs for each therapy, the small sample size of each study and the high risk of bias
in these trials. Further rigorous RCTs that focus on promising CAM therapies are warranted
Part of the MaRS BioEntrepreneurship series session: Clinical Trials Strategy
Speaker: Miklos Schulz
This is available as an audio presentation:
http://www.marsdd.com/bioent/feb12
Also view the event blog and summary:
http://blog.marsdd.com/2007/02/14/bioentrepreneurship-clinical-trial-strategies-its-never-too-soon/
A SYSTEMATIC REVIEW ON SELF-REPORTED QUESTIONNAIRES TO ASSESS MEDICATION ADH...Aji Wibowo
Adherence to pharmacological therapies are keys to effective treatments in diabetic patients. Previous reviews found that most adherence measurement studies on chronic diseases used a self-reported scale. However, there is no consensus on the best scale to measure adherence in diabetic patients. The purpose of this systematic review was to identify the potential self-reported scale that could be considered for measuring medication adherence in diabetic patients and to provide recommendations for researchers or clinicians to determine appropriate adherence selfreported scales in diabetic patients. This review follows general guidelines in the implementation of systematic reviews. After further review, it was found that 33 studies met all inclusion criteria from 4 databases (Wiley, Science Direct, Scopus, and PubMed). The articles were done by the PRISMA, while the keywords were determined by the PICO method. Most research was conducted in Asia (69.7%) and America (18.2%) on patients with type 2 diabetes (81.3%), patients in hospitals (54.5%), suffering for 1-6 months (54.5%), and using a cross-sectional study design (78.8%). HbA1c clinic data (57.6%) were used in most studies as biological markers of adherence. The measurement scales of medication adherence in diabetic patients are MMAS-8 (57,.5%), MMAS-4 (12.1%), BMQ (9%), MCQ (6%), ARMS (3%), ARMS-D (3%), GMAS (3%), LMAS-14 (3%), and MARS-5 (3%). This review provides information on the different self-reported scales most widely used in diabetic medication adherence research. Various aspects need to be considered before choosing the scale of adherence.
Medical Conferences, Pharma Conferences, Engineering Conferences, Science Conferences, Manufacturing Conferences, Social Science Conferences, Business Conferences, Scientific Conferences Malaysia, Thailand, Singapore, Hong Kong, Dubai, Turkey 2014 2015 2016
Global Research & Development Services (GRDS) is a leading academic event organizer, publishing Open Access Journals and conducting several professionally organized international conferences all over the globe annually. GRDS aims to disseminate knowledge and innovation with the help of its International Conferences and open access publications. GRDS International conferences are world-class events which provide a meaningful platform for researchers, students, academicians, institutions, entrepreneurs, industries and practitioners to create, share and disseminate knowledge and innovation and to develop long-lasting network and collaboration.
GRDS is a blend of Open Access Publications and world-wide International Conferences and Academic events. The prime mission of GRDS is to make continuous efforts in transforming the lives of people around the world through education, application of research and innovative ideas.
Global Research & Development Services (GRDS) is also active in the field of Research Funding, Research Consultancy, Training and Workshops along with International Conferences and Open Access Publications.
International Conferences 2014 – 2015
Malaysia Conferences, Thailand Conferences, Singapore Conferences, Hong Kong Conferences, Dubai Conferences, Turkey Conferences, Conference Listing, Conference Alerts
Works Cited Milne, Anne C., Alison Avenell, and Jan Potter. Meta-.docxkeilenettie
Works Cited
Milne, Anne C., Alison Avenell, and Jan Potter. "Meta-Analysis: Protein and Energy Supplementation in Older People."
Annals of Internal Medicine
144.1 (2006): 37-48.
ProQuest.
Web. 1 Oct. 2014.
Meta-Analysis: Protein and Energy Supplementation in Older People Anne C. Milne, MSc; Alison Avenell, MD; and Jan Potter, MBChB Background: Protein and energy undernutrition is common in older people, and further deterioration may occur during illness. Purpose: To assess whether oral protein and energy supplementa tion improves clinical and
nutritional outcomes for older people in the hospital, in an institution, or in the community. Data Sources: Cochrane Central Register of Controlled Trials (CEN TRAL), MEDLINE, EMBASE,
HealthStar, CINAHL, BIOSIS, and CAB abstracts. The authors included English- and non-English-language studies and hand-searched journals, contacted manufacturers, and sought information from trialists. The date of the most recent search of CENTRAL and MEDLINE is June 2005. Study Selection: Randomized and quasi-randomized controlled tri als of oral protein and energy
supplementation compared with placebo or control treatment in older people. Data Extraction: Two reviewers independently assessed trials for inclusion, extracted data, and assessed trial quality. Differences were resolved by consensus. Data Synthesis: Fifty-five trials were included (n = 9187 randomly tions (Peto odds ratio, 0.72 [95% Cl, 0.53 to 0.97]) and reduced mortality (Peto odds ratio, 0.66 [CI, 0.49 to 0.90]) for those un dernourished at baseline. Few studies reported evidence that suggested any change in mortality, morbidity, or function for those given supplements at home. Ten trials reported gastrointestinal disturbances, such as nausea, vomiting, and diarrhea, with oral supplements. Limitations: The quality of most studies, as reported, was poor, particularly for concealment of allocation and blinding of outcome assessors. Many studies were too small or the follow-up time was too short to detect a statistically significant change in clinical out come. The clinical results are dominated by 1 very large recent trial in patients with stroke. Although this was a high-quality trial, few participants were undernourished at baseline. Conclusions: Oral nutritional supplements can improve nutritional status and seem to reduce mortality and complications for under nourished elderly patients in the hospital. Current evidence does not support routine supplementation for older people at home or for well-nourished older patients in any setting. assigned participants). For patients in short-term care hospitals who were given oral supplements, evidence suggested fewer complica-Ann Intern Med. 2006:144:37-48. For author affiliations, see end of text.
www.annals.OIJ
ndernutrition among older people is a continuing source of concern (1, 2). Older people have longer periods of illness and longer hospital stays (3), and data show tha.
Running head CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS.docxtodd271
Running head: CRITIQUE QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
5
CRITIQUE OF QUANTITATIVE, QUALITATIVE, OR MIXED METHODS DESIGN
Critiquing Quantitative, Qualitative, or Mixed Methods Studies
Adenike George
Walden University
NURS 6052: Essentials of Evidence-Based Practice
April 11, 2019
Critique of Quantitative, Qualitative, or Mixed Method Design
Both quantitative and qualitative methods play a pivotal role in nursing research. Qualitative research helps nurses and other healthcare workers to understand the experiences of the patients on health and illness. Quantitative data allows researchers to use an accurate approach in data collection and analysis. When using quantitative techniques, data can be analyzed using either descriptive statistics or inferential statistics which allows the researchers to derive important facts like demographics, preference trends, and differences between the groups. The paper comprehensively critiques quantitative and quantitative techniques of research. Furthermore, the author will also give reasons as to why qualitative methods should be regarded as scientific.
The overall value of quantitative and Qualitative Research
Quantitative studies allow the researchers to present data in terms of numbers. Since data is in numeric form, researchers can apply statistical techniques in analyzing it. These include descriptive statistics like mean, mode, median, standard deviation and inferential statistics such as ANOVA, t-tests, correlation and regression analysis. Statistical analysis allows us to derive important facts from data such as preference trends, demographics, and differences between groups. For instance, by conducting a mixed methods study to determine the feeding experiences of infants among teen mothers in North Carolina, Tucker and colleagues were able to compare breastfeeding trends among various population groups. The multiple groups compared were likely to initiate breastfeeding as follows: Hispanic teens 89%, Black American teens 41%, and White teens 52% (Tucker et al., 2011).
The high strength of quantitative analysis lies in providing data that is descriptive. The descriptive statistics helps us to capture a snapshot of the population. When analyzed appropriate, the descriptive data enables us to make general conclusions concerning the population. For instance, through detailed data analysis, Tucker and co-researchers were able to observe that there were a large number of adolescents who ceased breastfeeding within the first month drawing the need for nurses to conduct individualized follow-ups the early days after hospital discharge. These follow-ups would significantly assist in addressing the conventional technical problems and offer support in managing back to school transition (Tucker et al., 2011).
Qualitative research allows researchers to determine the client’s perspective on healthcare. It enables researchers to observe certain behaviors and experiences amo.
EVIDENCE –BASED PRACTICES 1
Evidence-Based Practices
Stephanie Petit-homme
Miami Regional University
Professor: Garcia Mercedes
07/05/2021
Evidence-Based Practices to Guide Clinical Practices
In other terms recognized as evidence-based medication, evidence-based scientific practice is elucidated as the careful, obvious, and judicious use of the best indication in creating results for the outstanding care of separate patients. It helps those who brand the choices to device best healthcare practices while drawing the roadmaps for the health system. In clinical trials, the integration of the EBCP entails clinical respiratory medicine considers two fundamental principles. For example, the principle is the hierarchy of the evidence and the art of clinical decision-making.
The interrelationship between the theory, research, and EBP
The relationship between the theory, research, and the EBP supports the three recognition programs. They still relate in terms of the magnet model component of modern knowledge, innovation, and advancement. They describe in a way in which they lead to the promotion of quality in a setting that makes supports professional practices. Second, there is the identification of excellence in giving nursing services to sick people or the people who stay around. For instance, the model, which is other terms the magnet theory, has got five components ( Reddy, 2018).
The first constituent includes transformational management; the additional is structural authorization. The third one is archetypal specialized practices, new information, invention, and upgrading. Lastly, in the model, there are the empirical quality outcomes. For the achievement of the aims of the goals that have been set, there is a need to make sure that the theory, current knowledge innovation, and the improvements and the components that are found in view all the nurses who are located in the levels of the healthcare company need to get involved.
The research has its primary purpose for the help of coming up with knowledge or the validation done for the knowledge that has always been there from before based on the theory. There is systematic, scientific questioning in the research to give the answers to some of the specific questions. It can use the test hypotheses and the rigorous method, the primary purpose of the study being for investigation knowing of the new things and the exploration. There is a need to understand the philosophy of science.
Second, on the EBP, there is no development of the new knowledge or even the learning being validated. The primary purpose of the EBP is to translate the evidence and then apply it to medical executive. It uses the indication available to brand patient-care choices. The EBP goes yonder the exploration as fine as the persevering penchants and ideals. The EBP retains into deliberation that the best indication is for the opinion leaders and the experts. Even though there is the existence of definitiv ...
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Critical Appraisal Tools Worksheet
Template
)
Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment,Evidence-Based Project, Part 4A: Critical Appraisal of Research
Full citation of selected article
Article #1
Article #2
Article #3
Article #4
Ashcroft, D., Lewis, P., Tully, M., Farragher, T., Taylor, D., & Wass, V., Williams, S. D., & Dornan, T. (2015). Prevalence, Nature, Severity and Risk Factors for Prescribing Errors in Hospital Inpatients: Prospective Study in 20 UK Hospitals. Drug Safety, 38(9), 833-843. DOI: 10.1007/s40264-015-0320-x
Carayon, P., Wetterneck, T., Cartmill, R., Blosky, M., Brown, R., & Kim, R., Kukreja, S., Johnson, M., Paris, B., Wood, K. E., & Walker, J. (2014). Characterising the complexity of medication safety using a human factors approach: an observational study in two intensive care units. BMJ Quality & Safety, 23(1), 56-65. DOI: 10.1136/bmjqs-2013-001828
Hines, S., Kynoch, K., & Khalil, H. (2018). Effectiveness of interventions to prevent medication errors. JBI Database Of Systematic Reviews And Implementation Reports, 16(2), 291-296. DOI: 10.11124/jbisrir-2017-003481
Khalil, H., Chambers, H., Sheikh, A., Bell, B., & Avery, A. (2017). Professional, structural and organisational interventions in primary care for reducing medication errors. Cochrane Database System Review, 10 (CD003942). DOI: 10.1002/14651858.CD003942.pub3.
Conceptual Framework
Describe the theoretical basis for the study
The study deduced the reasoning that doctors during their first year of post-graduate training are prone to making disproportionate errors in their prescription.
Safety during medication is a significant issue in healthcare more so in intensive care units (ICUs). Therefore, the complexity of the medication management process is reflected on the convolution of evaluating medication errors and adverse drug events in ICUs.
This study seeks to assess the effectiveness of interventions developed to avert medication error during administration of medication, medication-related death, and medication-related harms among acute care patients.
During primary care, there are adverse events associated with medication and they represent a significant cause of hospital admission and mortality and these events could be as a result of patient going through adverse drug reactions or medication errors and the latter is preventable.
Design/Method Describe the design and how the study
was carried out
The study used pharmacists as their subjects across 20 health facilities over 7 selected days and the data was collected based on the number of checked medication orders, details of the prescribing errors, and the prescriber’s grade.
As part of the study’s methodology, the research has assessed the effect of electronic medical record on the safety and quality across ICUs by having cross-sectional study which has reported on the medication safety before EHR was used in two ICU facilities ...
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
1. INTRODUCTION
Shay Consulting, LLCShay Consulting, LLC
Five research questions assessed similarities or significant differences in the study populations based upon
recruitment of the subjects through physician efforts or a centralized recruitment campaign. The questions
focused on the likelihood for enrollment, compliance to treatment, completion of the clinical trial,
physiological symptoms, and psychological characteristics of the subjects.
The source data provided 1,204 screened subjects, which represented 591 enrolled subjects and 613 screen
failures. Of the 591 enrolled subjects, 424 subjects completed the clinical trial and 167 discontinued from
the clinical trial (Table 1). The central advertising campaign was anticipated to provide approximately 50%
of the enrolled subjects for the clinical trial. Minor adjustments were made to account for missing data or
incomplete information. Based upon the overall sample size and distribution or frequency of adjustments,
these changes were not considered significant enough to change the analysis of the results.
OBJECTIVES
The objective of this study was to determine the practical
applications for using pharmaceutical recruitment and physician
recruitment and if there were differences in five key areas of
comparisons for the study population based upon the recruitment
method. The population characteristics for specific assessment were:
• Likelihood to enroll into the clinical trial (Enrollment)
• Compliance to blinded treatment (Treatment Compliance)
• Likelihood to complete the clinical trial (Trial Completion)
• Physiological characteristics (Physiological Symptomatology)
• Psychological characteristics (Psychological)
By reviewing these characteristics by recruitment method, it could be
determined if the pharmaceutical-recruited subjects were similar or
different from the physician-recruited subjects.
CONCLUSIONS
Traditionally, physicians recruited trial subjects, however the use of
centralized advertising campaigns by pharmaceutical companies have
become ever more utilized for recruitment efforts. While physicians
remains vital to a trial, the efforts by pharmaceutical companies help
shift some of the recruitment demands away from the site; allowing
them to focus on the subjects. It is therefore practical to understand
if different recruitment methods might change or skew a study
population. This study determined if potential differences or
similarities occurred between subjects recruited by the physicians and
a pharmaceutical company. It found that some of both occurred. The
pharmaceutical company efforts helped recruit potential subjects
from the general population that were similar to subjects recruited by
the physicians, but this particular campaign was limited by language
which affected recruitment of Hispanic subjects. The social impact of
this study provides insight about pharmaceutical company
recruitment. Since the National Library of Medicine has indicated that
clinical trials should reflect the broader diseased population, the
efforts of the pharmaceutical company can help support the
physicians’ efforts by recruiting from the broader population.
Together, both efforts can create a global good by allowing the trial
to reflect the population of post-approval use. These findings still
raise a question about the proper balance between the two
recruitment groups so that the intended characteristics of the
diseased population are maintained. However, since some differences
between physician and pharmaceutical recruited subjects can exist,
the potential of one group to bias the trial results also exist. As such,
some analysis by recruitment method can help ensure that variations
in the study population are minimal without skewing the data to
create positive study results.
Raymond Panas is a former student and current faculty member of Walden University and is
also current faculty at The George Washington University. He is a former employee and current
consultant for Sucampo Pharmaceuticals, Inc.
REFERENCES
1. Sergeant, E. (2007). Methods of clinical trial recruitment that have and will impact the
pharmaceutical industry. Drug Development 2007, 1, 38-40.
2. Longstreth, G., Hawkey, C., Mayer, A., Jones R., Naesdal, J., Wilson, I., Peacock, R., &
Wiklund, I. (2001). Characteristics of patients with irritable bowel syndrome recruited from
three sources: implications for clinical trials. Alimentary Pharmacology & Therapeutics, 15,
959-964.
3. Panas, R. (2008). Differences Among Subjects in a Pharmaceutical Clinical Trial as
Determined by Recruitment Method. Berkley, CA: The Berkeley Electronic Press.
4. Babbie, E. (2004). The practice of social research (10th ed.). Belmont, CA: Wadsworth.
5. Drossman, D., Patrick, D., Whitehead, W., Toner, B., Diamant, N., Hu, Y., Huanguang, J., &
Bangdiwala, S. (2000). Further validation of the IBS-QOL: A disease specific quality of life
questionnaire. American Journal of Gastroenterology, 95, 999-1007.
6. Bushnell, D., Reilly, M., Carmen, G., Martin, M., Ricci, J., Patrick, D., & McBurney, C.
(2006). Validation of electronic data capture of the Irritable Bowel Syndrome-Quality of Life
measure, the work productivity, and activity impairment questionnaire for irritable bowel
syndrome and the EuroQol. Value in Health, 9(2), 98-105.
Blinded data from a Phase 3 Irritable Bowel Syndrome clinical trial was retrospectively evaluated based upon a
quasi-experimental design since there was not a true control group for comparison.4
The original clinical trial
was a double blind, multicenter, randomized controlled trial conducted under strict guidelines that applied to
clinical drug trials involving human subjects. For this retrospective study, subjects were assigned to one of two
groups based upon their recruitment method (Figure 1) into the original trial. Subjects recruited by the
recruitment methods of the investigational sites were pooled to form the physician-recruited group (pseudo
control group). Recruitment through the centralized advertising campaign of the pharmaceutical company
made up the pharmaceutical-recruited group (study group of interest). The source data for this study analysis
was accessed from clinical trial enrollment reports, progress reports, and SAS datasets. Individual subject data
was captured via the IBS-QOL5,6
surveys, electronic case report forms, and electronic diaries.
Descriptive statistics was used for the demographic data. A Fisher’s Exact Test or t test (95% confidence level)
was utilized to test a hypothesis for the five key comparisons of the study population based upon the
recruitment methods – physician or centralized campaign. Enrollment used a count of screened and screen
failed subject and a two-tail Fisher’s Exact Test to determine if there was a significant different among the
recruitment groups. Treatment Compliance used data of enrolled subjects from the exposure dataset to
calculate overall compliance rates for each group based upon actual and expected monthly compliance.
ACKNOWLEGEMENT & CONTACT
This study was made possible by the support of Drs. Hadi A. Danawi, Chester S. Jones, and
William M. Barkley of Walden University and Drs. Ryuji Ueno and Sachiko Kuno of Sucampo
Pharmaceuticals, Inc. Contact: rpanas@shayconsulting.com
Drugs, both prescription and over-the-counter, are approved based
upon pharmacologic, safety, and efficacy data gathered from clinical
trials so pharmaceutical companies spend millions each year gathering
sufficient information to for this approval. The need to recruit
subjects to a clinical trial can create be very time consuming and
efforts to shorten the overall recruitment timeline can impact the
duration and costs of the trial.
Advertising for subject for a clinical trial is one way a pharmaceutical
company can helps accelerate subject recruitment and completion of
a clinical trial.1
Through advertising, pharmaceutical companies are
able to (a) enhance awareness about clinical trials, (b) refer subjects
to physicians conducting clinical trials, and (c) accelerate enrollment
into clinical trials, thereby shortening the timeline needed to conduct
clinical trials. Traditionally, physicians recruit patients for
participation in clinical trials from their own clinical practice,
referrals from other physicians, and their own local advertising
efforts,2
as outlined in Figure 1.
Figure 1. Subject recruitment and subject flowchart.3
RESULTS
METHODS
DISCLOSURES
A two-sample, two tailed t test was used to determine if there was a significant difference in the treatment
compliance rates of the two groups. Study Completion data from enrollment reports on enrolled subjects
determined the count of completed and discontinued subjects. A two-tail Fisher’s Exact Test was used to
determine if there was a significant difference in the two groups. For Physiological was assessed from baseline
data of enrolled subjects in the assessment, diary and bowel movement frequency datasets and to calculate an
IBS symptomatology composite score (abdominal discomfort, abdominal bloating, stool consistency, bowel
straining) and weekly bowel movement frequency. A two-tail t test determined if there was a significant
difference between the symptomatology composite scores for each group. In the event that a significant
difference was found, a comparison of individual symptoms for each group was made using a two-tail t test to
determine which individual symptoms were significantly different. A two-tail t test assessed the difference for
the weekly bowel movement frequency for each recruitment group. For the Psychological comparison, the first
IBS-QOL assessments of enrolled subjects was used from the IBS-QOL dataset to determine the overall
composite score for and individual domain scores of each group. A two-sample, two-tail t test determined if
there was a significant difference in composite score of each recruitment group. In the event that a significant
difference was found, a comparison of individual domains scores for each recruitment group was made using a
two-tail t test to determine which of the individual domains were significantly different.
Demographically, the population was typical for an IBS
study (Table 2). The two recruitment methods were
similar for subjects except for race. However, the
centralized advertising campaign was not translated
into Spanish which limited the potential to enroll
Hispanic subjects.
Physiological symptoms were mixed with similar
findings for a composite symptom score (Table 6) of
abdominal bloating, abdominal discomfort,
straining, and stool consistency, but a minor
difference for bowel movement frequency (Table 7)
with the centralized campaign subjects averaging
about one bowel movement more per week. No
significant difference was found for the
psychological assessment.
Overall results indicated that both recruitment methods found subjects who were similar in the likelihood to
enroll into the clinical trial (Table 3), treatment compliance (Table 4), and clinical trial completion (Table 5).
Potential Differences in Subjects from Physician Recruitment versusPotential Differences in Subjects from Physician Recruitment versus
Centralized Recruitment Campaigns in a Clinical TrialCentralized Recruitment Campaigns in a Clinical Trial
Principal Consultant, Shay Consulting, LLC
Faculty, The George Washington University & Walden University
Raymond M. Panas, PhDRaymond M. Panas, PhD