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Search Results: 1 - 10 of 475248 matches for " Christian A. Chisholm "
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Exploring UK attitudes towards unlicensed medicines use: a questionnaire-based study of members of the general public and physicians
Chisholm A
International Journal of General Medicine , 2012, DOI: http://dx.doi.org/10.2147/IJGM.S28341
Abstract: ring UK attitudes towards unlicensed medicines use: a questionnaire-based study of members of the general public and physicians Original Research (1870) Total Article Views Authors: Chisholm A Published Date January 2012 Volume 2012:5 Pages 27 - 40 DOI: http://dx.doi.org/10.2147/IJGM.S28341 Received: 17 November 2011 Accepted: 06 December 2011 Published: 10 January 2012 Alison Chisholm Omega Scientific, Yately, UK Aims: To undertake a questionnaire-based study to evaluate attitudes towards the use of unlicensed medicines among prescribing doctors and members of the general public (ie, patients). The study also aimed to explore the factors that influence physicians' prescribing decisions and priorities, and to understand the knowledge of the medicines licensing system among members of the public. Methods: Novartis Pharmaceuticals UK Ltd funded the online interview of 500 members of the general public and 249 prescribing physicians. Best practice standards were followed for questionnaire-based studies; no specific treatments or conditions were mentioned or discussed. Results: Few of the participating physicians, only 14%, were very familiar with the UK General Medical Council (GMC) guidelines on the use of unlicensed medicines and just 17% felt very comfortable prescribing an unlicensed medication when a licensed alternative was available. Key physician concerns included the lack of safety data (76%), legal implications (76%), and safety monitoring associated with unlicensed medicine use (71%). Patients and physicians agreed that safety and efficacy are the most important prescribing considerations, although 48% of participating physicians were worried that budget pressures may increase pressure to prescribe unlicensed medications on the basis of cost. A high proportion of patients (81%) also indicated some degree of concern, were they to be prescribed an unlicensed medication when a licensed alternative was available specifically because it costs less. Conclusions: This UK-based questionnaire study suggests pervasive concerns among prescribers over the safety, monitoring, and legal implications of unlicensed prescribing. High levels of concern were expressed among patients and physicians if cost were to become an influential factor when making decisions between licensed and unlicensed medications.
Exploring UK attitudes towards unlicensed medicines use: a questionnaire-based study of members of the general public and physicians
Chisholm A
International Journal of General Medicine , 2012,
Abstract: Alison ChisholmOmega Scientific, Yately, UKAims: To undertake a questionnaire-based study to evaluate attitudes towards the use of unlicensed medicines among prescribing doctors and members of the general public (ie, patients). The study also aimed to explore the factors that influence physicians' prescribing decisions and priorities, and to understand the knowledge of the medicines licensing system among members of the public.Methods: Novartis Pharmaceuticals UK Ltd funded the online interview of 500 members of the general public and 249 prescribing physicians. Best practice standards were followed for questionnaire-based studies; no specific treatments or conditions were mentioned or discussed.Results: Few of the participating physicians, only 14%, were very familiar with the UK General Medical Council (GMC) guidelines on the use of unlicensed medicines and just 17% felt very comfortable prescribing an unlicensed medication when a licensed alternative was available. Key physician concerns included the lack of safety data (76%), legal implications (76%), and safety monitoring associated with unlicensed medicine use (71%). Patients and physicians agreed that safety and efficacy are the most important prescribing considerations, although 48% of participating physicians were worried that budget pressures may increase pressure to prescribe unlicensed medications on the basis of cost. A high proportion of patients (81%) also indicated some degree of concern, were they to be prescribed an unlicensed medication when a licensed alternative was available specifically because it costs less.Conclusions: This UK-based questionnaire study suggests pervasive concerns among prescribers over the safety, monitoring, and legal implications of unlicensed prescribing. High levels of concern were expressed among patients and physicians if cost were to become an influential factor when making decisions between licensed and unlicensed medications.Keywords: patient, physician, unlicensed treatment, concern, safety, trust
Medical and Obstetric Complications among Pregnant Women Aged 45 and Older
Chad A. Grotegut, Christian A. Chisholm, Lauren N. C. Johnson, Haywood L. Brown, R. Phillips Heine, Andra H. James
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0096237
Abstract: Objective The number of women aged 45 and older who become pregnant is increasing. The objective of this study was to estimate the risk of medical and obstetric complications among women aged 45 and older. Methods The Nationwide Inpatient Sample was used to identify pregnant woman during admission for delivery. Deliveries were identified using International Classification of Diseases, Ninth Revision (ICD-9-CM) codes. Using ICD-9-CM codes, pre-existing medical conditions and medical and obstetric complications were identified in women at the time of delivery and were compared for women aged 45 years and older to women under age 35. Outcomes among women aged 35–44 were also compared to women under age 35 to determine if women in this group demonstrated intermediate risk between the older and younger groups. Logistic regression analyses were used to calculate odds ratios with 95% confidence intervals for pre-existing medical conditions and medical and obstetric complications for both older groups relative to women under 35. Multivariable logistic regression analyses were also developed for outcomes at delivery among older women, while controlling for pre-existing medical conditions, multiple gestation, and insurance status, to determine the effect of age on the studied outcomes. Results Women aged 45 and older had higher adjusted odds for death, transfusion, myocardial infarction/ischemia, cardiac arrest, acute heart failure, pulmonary embolism, deep vein thrombosis, acute renal failure, cesarean delivery, gestational diabetes, fetal demise, fetal chromosomal anomaly, and placenta previa compared to women under 35. Conclusion Pregnant women aged 45 and older experience significantly more medical and obstetric complications and are more likely to die at the time of a delivery than women under age 35, though the absolute risks are low and these events are rare. Further research is needed to determine what associated factors among pregnant women aged 45 and older may contribute to these findings.
Building a Morphogen Gradient without Diffusion in a Growing Tissue
Rebecca H. Chisholm,Barry D. Hughes,Kerry A. Landman
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0012857
Abstract: In many developmental systems, spatial pattern arises from morphogen gradients, which provide positional information for cells to determine their fate. Typically, diffusion is thought to be the mechanism responsible for building a morphogen gradient. An alternative mechanism is investigated here. Using mathematical modeling, we demonstrate how a non-diffusive morphogen concentration gradient can develop in axially growing tissue systems, where growth is due to cell proliferation only. Two distinct cases are considered: in the first, all cell proliferation occurs in a localized zone where active transcription of a morphogen-producing gene occurs, and in the second, cell proliferation is uniformly distributed throughout the tissue, occurring in both the active transcription zone and beyond. A cell containing morphogen mRNA produces the morphogen protein, hence any gradient in mRNA transcripts translates into a corresponding morphogen protein gradient. Proliferation-driven growth gives rise to both advection (the transport term) and dilution (a reaction term). These two key mechanisms determine the resultant mRNA transcript distribution. Using the full range of uniform initial conditions, we show that advection and dilution due to cell proliferation are, in general, sufficient for morphogen gradient formation for both types of axially growing systems. In particular, mRNA transcript degradation is not necessary for gradient formation; it is only necessary with localized proliferation for one special value of the initial concentration. Furthermore, the morphogen concentration decreases with distance away from the transcription zone, except in the case of localized proliferation with the initial concentration sufficiently large, when the concentration can either increase with distance from the transcription zone or sustain a local minimum. In both localized and uniformly distributed proliferation, in order for a concentration gradient to form across the whole domain, transcription must occur in a zone equal to the initial domain size; otherwise, it will only form across part of the tissue.
Thirty Years of Forest Census at Barro Colorado and the Importance of Immigration in Maintaining Diversity
Richard Condit, Ryan A. Chisholm, Stephen P. Hubbell
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0049826
Abstract: The neutral theory of community ecology can predict diversity and abundances of tropical trees, but only under the assumption of steady input of new species into the community. Without input, diversity of a neutral community collapses, so the theory's predictions are not relevant unless novel species evolve or immigrate. We derive analytically the species input needed to maintain a target tree diversity, and find that a rate close to per recruit would maintain the observed diversity of 291 species in the Barro Colorado 50-ha tree plot in Panama. We then measured the rate empirically by comparing species present in one complete enumeration of the plot to those present five years later. Over six census intervals, the observed rate of input was to species per recruit, suggesting that there is adequate immigration of novel species to maintain diversity. Species interactions, niche partitioning, or density-dependence, while they may be present, do not appear to enhance tree species richness at Barro Colorado.
New identities from quantum-mechanical sum rules of parity-related potentials
O. A. Ayorinde,K. Chisholm,M. Belloni,R. W. Robinett
Physics , 2010, DOI: 10.1088/1751-8113/43/23/235202
Abstract: We apply quantum mechanical sum rules to pairs of one-dimensional systems defined by potential energy functions related by parity. Specifically, we consider symmetric potentials, $V(x) = V(-x)$, and their parity-restricted partners, ones with $V(x)$, but defined only on the positive half-line. We extend recent discussions of sum rules for the quantum bouncer by considering the parity-extended version of this problem, defined by the symmetric linear potential, $V(z) = F|z|$ and find new classes of constraints on the zeros of the Airy function, $Ai(z)$, and its derivative $Ai'(z)$. We also consider the parity-restricted version of the harmonic oscillator and find completely new classes of mathematical relations, unrleated to those of the ordinary oscillator problem. These two soluble quantum-mechanical systems defined by power-law potentials provide examples of how the form of the potential (both parity and continuity properties) affects the convergence of quantum-mechanical sum rules. We also discuss semi-classical predictions for expectation values and the Stark effect for these systems.
Progresso e mimesis: ideias políticas, imita??o e desenvolvimento
Chisholm, Robert;
Lua Nova: Revista de Cultura e Política , 2009, DOI: 10.1590/S0102-64452009000200004
Abstract: comparative political science has ignored the central role that political ideas and models have on the creation and development of institutions. with the collapse of the soviet bloc and the intellectual fervor that accompanied this event, possibilities of paying attention to the effects of political thought grew. articulated by political thinkers, ideas direct actions, reflect dominant understandings among elites on the truth or provide a basis for criticism of these understandings. in this sense, their study may reveal some aspects of the effort to set up a regime. this article suggests an approach to the problem: focusing on how ideas are adopted, adapted and supported by the political actors.
Impact of clinical pharmacy services on renal transplant recipients’ adherence and outcomes
Marie A Chisholm-Burns, Christina A Spivey, Charlene Garrett, Herbert McGinty, Laura L Mulloy
Patient Preference and Adherence , 2008, DOI: http://dx.doi.org/10.2147/PPA.S4174
Abstract: ct of clinical pharmacy services on renal transplant recipients’ adherence and outcomes Rapid Communication (5230) Total Article Views Authors: Marie A Chisholm-Burns, Christina A Spivey, Charlene Garrett, Herbert McGinty, Laura L Mulloy Published Date October 2008 Volume 2008:2 Pages 287 - 292 DOI: http://dx.doi.org/10.2147/PPA.S4174 Marie A Chisholm-Burns1, Christina A Spivey1, Charlene Garrett2, Herbert McGinty2, Laura L Mulloy3 1Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tuscon, AZ, USA; 2Medication Access Program (MAP), University of Georgia College of Pharmacy, Athens, GA, USA; 3Section of Nephrology, Hypertension and Transplantation Medicine, Medical College of Georgia School of Medicine, Augusta, GA, USA Abstract: The purpose of this article is to provide a description of a clinical pharmacy services program implemented in a renal transplant clinic to improve medication access and adherence as well as health and economic outcomes among renal transplant recipients (RTRs). Following a team-based planning process and an informal survey of RTRs, a clinical pharmacy service intervention was implemented in the Medical College of Georgia renal transplant clinic. As part of the intervention, a clinical pharmacist reviewed and optimized medication therapy, provided instructions on how to take medication, and assisted with enrollment into medication assistance programs. Significant differences were found between RTRs who did and did not receive clinical pharmacy services on measures of adherence, health, economics, and quality of life. Clinical pharmacy services, as described in this article, have a positive impact on renal transplant recipients’ medication adherence, health and economic outcomes, and health-related quality of life. The findings described here suggest that clinical pharmacy services are a viable and effective option for improving care for RTRs in an outpatient clinic setting.
Impact of clinical pharmacy services on renal transplant recipients’ adherence and outcomes
Marie A Chisholm-Burns,Christina A Spivey,Charlene Garrett,Herbert McGinty
Patient Preference and Adherence , 2008,
Abstract: Marie A Chisholm-Burns1, Christina A Spivey1, Charlene Garrett2, Herbert McGinty2, Laura L Mulloy31Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tuscon, AZ, USA; 2Medication Access Program (MAP), University of Georgia College of Pharmacy, Athens, GA, USA; 3Section of Nephrology, Hypertension and Transplantation Medicine, Medical College of Georgia School of Medicine, Augusta, GA, USAAbstract: The purpose of this article is to provide a description of a clinical pharmacy services program implemented in a renal transplant clinic to improve medication access and adherence as well as health and economic outcomes among renal transplant recipients (RTRs). Following a team-based planning process and an informal survey of RTRs, a clinical pharmacy service intervention was implemented in the Medical College of Georgia renal transplant clinic. As part of the intervention, a clinical pharmacist reviewed and optimized medication therapy, provided instructions on how to take medication, and assisted with enrollment into medication assistance programs. Significant differences were found between RTRs who did and did not receive clinical pharmacy services on measures of adherence, health, economics, and quality of life. Clinical pharmacy services, as described in this article, have a positive impact on renal transplant recipients’ medication adherence, health and economic outcomes, and health-related quality of life. The findings described here suggest that clinical pharmacy services are a viable and effective option for improving care for RTRs in an outpatient clinic setting.Keywords: renal transplant recipients, immunosuppressant therapy adherence, health outcomes, economic outcomes
Growth patterns in Onychophora (velvet worms): lack of a localised posterior proliferation zone
Georg Mayer, Chiharu Kato, Bj?rn Quast, Rebecca H Chisholm, Kerry A Landman, Leonie M Quinn
BMC Evolutionary Biology , 2010, DOI: 10.1186/1471-2148-10-339
Abstract: Using in vivo incorporation of the DNA replication marker BrdU (5-bromo-2'-deoxyuridine) and anti-phospho-histone H3 immunolabelling, we found that a localised posterior region of proliferating cells does not occur at any developmental stage in onychophoran embryos. This contrasts with a localised pattern of cell divisions at the posterior end of annelid embryos, which we used as a positive control. Based on our data, we present a mathematical model, which challenges the paradigm that a localised posterior proliferation zone is necessary for segment patterning in short germ developing arthropods.Our findings suggest that a posterior proliferation zone was absent in the last common ancestor of Onychophora and Arthropoda. By comparing our data from Onychophora with those from annelids, arthropods, and chordates, we suggest that the occurrence of a "posterior growth zone" currently cannot be used to support the homology of segmentation between these three animal groups.The most obvious subdivision of the body into serially repeated units or segments occurs in annelids (ringed worms), panarthropods (onychophorans, tardigrades and arthropods), and chordates (including vertebrates, urochordates and cephalochordates). During embryonic development, segments are commonly believed to originate from the so-called "posterior growth zone" (review [1]). However, this term has been applied very broadly in the past, which has resulted in ambiguity. For example, the occurrence of a "posterior growth zone" has been used to support the homology of segmentation either specifically in annelids and panarthropods [2-4] or in all three groups of segmented animals, suggesting that segmentation was present in their last common ancestor [1,5-8].Traditionally, the term "posterior growth zone" has been used to describe a localised and highly proliferative terminal body region, which has been dubbed the "proliferating area" or "zone of proliferation" [9-11]. While it seems clear that such a loca
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