AIDS helping other women with HIV AIDS by providing encouragement and empowerment in a nurturing supportive environment. We deal with all matters of the heart, because they are just as important as other types of services and support. As a result our program has a set of guiding principles that include the key words: comprehensiveness, coordination, collaboration, and most importantly self-empowerment. In essence when you walk into the doors of the Collective to get case management services you have "hired" us to be your partner in getting the care and services you need. The Women's Collective case management services are family-centered. What does that mean? It means that we provide services for the woman as a client, and also for her children and other family members. Why is that important? It's important because most of us don't feel well unless our "family" however you define your family ; is okay. Your emotional well being has a direct relationship to your physical wellbeing. Ask any mother how she's doing and within minutes she will tell you something about the kids. If you don't have food or clothes for the kids, then you're probably not thinking about taking your medications. If you can't pay the rent, then you probably won't think about taking care of your health. So that's where Pat began when she started the organization and it's at the core of our mission. We wanted to change the status quo, we did not want to force women into a rigid program.
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Occasionally client is too exhausted to absorb much information [C]an provide written resources and opportunity to return within 72 hours. Still see clients in follow-up who lack knowledge or are taking medications incorrectly or with no anti-emetics. Can mean the difference between stopping medications and completing course Nurse, Respondent 133 ; . One SANE stated that increased visit time due to counselling had negative implications for clients, [A]ll response calls seem to be very labour intensive now and take much longer - average time to do study and [forensic] kit is at least 4 hours, more like 4 to 6 hours. Have had the next client have to wait 1 hours before I could complete all the paperwork! Respondent 61 ; . It important to note, however, that strategies to resolve such issues were posed by several SANEs, Our program has changed so that we deal with the HIV PEP question at the start of the visit. We have changed the order of our chart to reflect this Respondent 53 ; . I try to keep it simple and basic then provide the literature for patient to follow-up at home to read. Of course I answer any questions Respondent 54 ; Often found on initial contract the counselling given wasn't always taken in if long, but if kept short, key aspect was okay. Then on next visit with follow-up nurse counselling was redone - the person got more of the message Respondent 79 ; . Just over one-quarter of HCPs felt that there was not n 16, 14.4% ; , or they were unsure n 12, 10.8% ; whether there was, enough time or opportunity for sufficient HIV PEP counselling. One of the main reasons given for a "no" response was the amount of material to cover, Seeing a client . is exhausting both for the client and nurse. After forensic exam and going over all other health concerns - spending a whole chunk of time on HIV PEP was hard on the nurse and client, therefore the process was often rushed Nurse, Respondent 4 ; . Several others stated that adequate counselling was not possible due to some clients' desire to shorten the therapeutic encounter or the impact on them emotionally of discussing HIV, Depends - some clients most ; very anxious and exhausted and want to be finished and go home. Also very overwhelmed, which can keep them from wanting to discuss or participate in counselling SANE, Respondent 107 ; . At the time of caring for the victims of sexual assault - the majority are unable to absorb and comprehend information regarding HIV PEP - once they hear HIV it further stresses them SANE, Respondent 105 ; . Again, however, several HCPs cited follow-up visits as an opportunity to "provide . more . counselling" SANE, Respondent 102 ; . Quality of Care: Client Satisfaction When asked whether clients were generally satisfied with the care received, almost three-fifths n 77; 58.3% ; responded, "yes". HCPs who commented further, cited evidence from those receiving care themselves as well as from their family members. A Nurse who had provided both initial and and
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The prevailing theory is that the phospholipidosis is primarily an adaptive response to CAD exposure rather than a toxic response. In this case, the cell adapts to the drug exposure by sequestering it in the lamellar bodies, thus reducing potential toxicity to intracellular structures. In the process of doing this, however, concentrations of the drug can reach millimolar levels in the lamellar bodies 50 ; . Studies have failed to definitively show that the presence of CAD-induced phospholipidosis is detrimental to the organism. Isolated cell studies have demonstrated that the presence of the condition may or may not result in changes in pulmonary cellular function, and where this occurs, the consequences to the intact organism are unknown. Additionally, studies involving whole animals have not demonstrated adverse effects attributable to the presence of CADphospholipidosis, at least for the lungs. These studies have been summarized previously 2, 17, 51 ; and will not be reviewed here. The following discussion will expand upon certain studies that highlight what the authors believe are illustrative of our state of knowledge in this field. Reasor et al. 51 ; administered amiodarone to rats, inducing phospholipidosis in alveolar macrophages. Using this model, a number of pulmonary host defense functions were evaluated. The pulmonary clearance of Listeria monocytogenes was not affected by the phospholipidotic condition. Using an ex vivo alveolar macrophage culture system, the presence of the phospholipidosis had no effect on the phagocytosis of heat-killed yeast cells, the induction of luminol-dependent chemiluminescence, the spontaneous release of interleukin-6 or tumor necrosis factor- , or spontaneous and LPS-stimulated release of interleukin-1. In contrast, the LPS-stimulated release of interleukin-6 and tumor necrosis factor- was enhanced compared with nonphospholipidotic cells. In the context of the functions studied, the induction of pulmonary phospholipidosis appeared not to impair pulmonary host defense processes in rats. A study by Ferin 52 ; demonstrated impaired pulmonary clearance of particles in rats treated with the CAD chlorphentermine, but the presence of phospholipidosis in the lungs was not verified. Sun et al. 53 ; examined the effects of the CAD amiodarone on rat and human hepatocytes, ex vivo. They reported that the induction of lamellar bodies preceded a decrease in cell function, which preceded cell death. The results could be interpreted that the induction of lamellar bodies is not directly associated with toxicity, but rather toxicity may result from higher drug concentration in the tissue tissue overdose effect ; . However, as the number of lamellar bodies within cells reached high levels, cytotoxicDRUG-INDUCED PHOSPHOLIPIDOSIS 827.
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J. Soleimani Rad, K. Sadegi, A. Alizadeh. Depts of Anatomical Sciences & Ophthalmology, Faculty of Medicine, Medical Sciences University of Tabriz, Tabriz Iran Acetazolamide as a carbonic anhydrase inhibitor is widely used for decreasing intraocular pressure in treatment of Glaucoma. Acetazolamide administration causes ciliary body inflammation and a transient myopia. In the present study the effect of Acetazolamide on developing eye have been investigated. For this purpose, pregnant wistar rats are divided in control and experimental groups. In the experimental group, from 6th day of pregnancy onward, rats received 70 mg Acetozolamide day for 10 days orally ; . After delivery, 1 day old and 5 days old newborns, both in control and experimental groups were sacrificed and their eyes were fixed in 10% formaldelyde and prepared for light microscopic and morphometric studies. The results show that in control group, the thickness of cornea was 2.430.30 mm, while in Acetazolamide injected rats it reduced to 1.68 0.16mm. The difference between two groups were statically significant P 0.001 ; . Additionally, in corneal stroma, muclei of fibroblasts became round and vesicular. While, nuclei in corneal epithelium and endothelium were more condensed than those in control group. Histological studies of Lens revealed that in experimental group, Lens fibers were arranged irregulary . in the lining of ciliary process, Acetazolamide injection produced vesicular nuclei and the two layers of pigmented and nonpigmented cells were not easily distinctive. Retinal study did not show a significant changes when compared to control group. It is concluded that Acetazolamide administration during pregnancy produces minor disorders. However, further studies are needed to clarify if these changes could result in visual defect or not.
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Regulation Pharmaceuticals GlaxoSmithKline operates within a highly regulated environment. Regional and country-specific laws and regulations define the data required to show safety and efficacy of pharmaceutical products, as well as govern testing, approval, manufacturing, labelling and marketing of drugs. These regulatory requirements are a major factor in determining whether a marketable product may be successfully developed and the amount of time and expense associated with this development. Regulation process In 2004 GlaxoSmithKline adopted the Common Technical Document format for marketing applications and major supplements. This is a single format for registering a product that is accepted by regulatory authorities in many regions. These applications are being prepared and submitted electronically. Other harmonisation activities at a global and regional level are ongoing with some success at standardisation. However, the regulatory environment is varied and changes rapidly. The national regulatory authorities in many jurisdictions have high standards of technical appraisal and consequently the introduction of new pharmaceutical products generally entails a lengthy approval process. In the European Union, there are currently two procedures for obtaining marketing authorisations for medicinal products: The Centralised Procedure, with applications made direct to the European Medicines Evaluation Agency and leading to an authorisation valid in all member states, is compulsory for products derived from biotechnology and optional for new active substances and other innovative medicinal products The Mutual Recognition Procedure, which is applicable to the majority of conventional medicinal products, operates by mutual recognition of national marketing authorisations. Where agreement cannot be reached, it is resolved by a procedure of binding arbitration. New EU legislation is to be implemented by the end of 2005, which will improve the Centralised Procedure and increase the range of products for which it is compulsory. The Mutual Recognition Procedure the decentralised procedure ; , which is intended to facilitate agreement between the member states, will also be amended. The implementation of the new legislation will bring with it a number of other changes, for example, increased post marketing safety monitoring and new types of conditional product approvals. Grant of a marketing authorisation affords the Group a protection period during which a competitor cannot rely on confidential data in the regulatory file as a basis for its own marketing authorisation. The new EU legislation will, for the first time, harmonise the data protection period for both submission routes. The FDA has introduced a new focus called the Critical Path Initiative. This is intended to enable innovation in drug development, hopefully allowing for more rapid development and approval of needed medicines. This initiative will investigate the use of pharmacogenomics and surrogate markers of efficacy, among other things, such as manufacturing innovations, as tools for rapidly developing and producing safe and effective drugs for unmet medical needs and
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Radioactive seed placement and radiation dose distribution. Prostate brachytherapy as monotherapy has become a popular treatment option for early, clinically organ-confined prostate cancer cT1cT2a, Gleason grade 2-6, PSA 10 ng mL ; The advantage of brachytherapy is that the treatment is completed in 1 day with little time lost from normal activities. In appropriate patients, the cancer-control rates appear comparable to surgery for low-risk tumors with medium-term follow up. In addition, the risk of incontinence is minimal in patients without a previous transurethral resection of the prostate TURP ; , and erectile function is preserved in the short term. Disadvantages of brachytherapy include the requirement for general anesthesia and the risk of acute urinary retention. The treatment should be appropriately limited to selected patients with small-volume prostate glands 60 gm ; . Frequently, irritative voiding symptoms may persist for as long as 1 year after implantation. The risk of incontinence is great after TURP because of acute retention and bladder neck contractures, and many patients develop progressive erectile dysfunction over several years. Permanent brachytherapy as monotherapy is indicated for patients with low-risk cancers. For intermediate-risk cancers, brachytherapy may be combined with external-beam RT 40-50 Gy ; with or without neoadjuvant ADT, but the complication rate increases. Patients with high-risk cancers are generally considered poor candidates for permanent brachytherapy; however, with the addition of external-beam RT and neoadjuvant ADT, brachytherapy may be effective in select patients. Patients with large prostates 60 g ; , small prostates 15-20 gr ; , symptoms of bladder outlet obstruction International Prostate Symptom Score 15 ; , or a previous TURP are not ideal candidates for brachytherapy because of increased risk of urinary morbidity. Neoadjuvant ADT may be used to shrink the prostate to an acceptable size. Postimplant dosimetry should be performed to document the, because herbal phentermine.
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All patients included had a chronic condition requiring continuous daily treatment with one or more oral NSAIDs including selective COX-2 inhibitors and high-dose aspirin [ 325 mg day] ; for at least 5 days in any given week for the duration of the study. Patients using low-dose aspirin 325 mg day ; in conjunction with an NSAID or COX-2 inhibitor were allowed to participate in the study but were categorised as receiving nonselective NSAID therapy reflecting the COX-1 inhibitory effects of this therapy ; regardless of whether aspirin was used alone or in combination with a non-selective NSAID or a selective COX-2 inhibitor. For assessment of the effect of NSAID type on study variables, patients were included in the selective COX-2 inhibitor group only if they were taking a selective COX-2 inhibitor alone. Exclusion criteria included pain, discomfort, or burning in the upper abdomen precipitated by exercise, relieved by defecation, or not associated with the use of NSAIDs; a history of symptomatic gastroesophageal reflux disease GERD ; not associated with the use of NSAIDs; a history of erosive esophagitis, gastric, or duodenal ulcer or of esophageal, gastric, or duodenal surgery; a need for concomitant therapy with drugs likely to affect the outcome of the study stable treatment with disease-modifying anti-rheumatic drugs was permitted, as was limited glucocorticoid use and
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Appendix 1 .30 Resolution by kava industry representatives at the Pacific Herbs Business Forum .30 List of contacted organizations and associations.32 List of contacted delegates of the Pacific Herbs Business Forum, Port Vila, Vanuatu, 18-20 February 2002.35 List of contacted German pharmaceutical companies using kava .39.
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Ando, Amy Whitenour. 1999. "Waiting to be Protected under the Endangered Species Act: The Political Economy of Regulatory Delay, " Journal of Law and Economics 42: 29-60. Avorn, Jerome. 2004. Powerful Medicines New York: Knopf ; . Bowers, Jake, Daniel Carpenter, et al. 2007. "User-Fee Institutions and Postmarketing Regulatory Events: Results from Robust Matching Analyses, " Department of Government, Harvard University. Carpenter, Daniel. 2002. "Groups, the Media, Agency Waiting Costs, and FDA Drug Approval, " American Journal of Political Science 46 July 2002 ; 3 ; : 490-505.
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ECDPM Study on Capacity, Change and Performance, Background Paper, 15-17 May 2006 Peter Morgan ; 2 Development Effectiveness in Fragile States: Spillovers and Turnarounds, Chauvet and Collier, Oxford University, January 2004 3 Although it is not without its critics. Patricia Dunn talk at IPAA NSW forum 25 May 2006 Page 5.
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THE SCHOOL BOARD OF POLK COUNTY, FLORIDA 1915 SOUTH FLORAL AVENUE, BARTOW, FL 33830 PHONE NUMBER 863 534-0500 FAX NUMBER 863 534-0737 DRUG TESTING POLICY SUMMARY It is the policy of THE SCHOOL BOARD OF POLK COUNTY, FLORIDA Employer ; to employ a work force free from the use of illegal drugs; accordingly, it is a condition of School Board employment that all employees or job applicants submit to drug screening under the following circumstances: 1. Pre-Employment - On a post-job offer basis when a final job candidate has been selected for a position. Any final job candidate who refuses to take a drug test or who has a positive test result will be denied employment at that time but may reapply after six 6 ; months. Reasonable Suspicion - When there is reasonable suspicion to believe that an employee is using or has used illegal drugs. Circumstances that could be indicators of a drug problem and considered reasonable suspicion are: a. Observable phenomena at work such as direct observation of drug use or the physical symptoms or manifestations of being under the influence of a drug; b. Abnormal conduct or erratic behavior while at work or a significant deterioration in work performance; c. A report of drug use, provided by a reliable and credible source; d. Evidence that an individual has tampered with a drug test during his her employment with the current employer; e. Information that an employee has caused, contributed to, or been involved in an accident while at work; or f. Evidence that an employee has used, possessed, sold, solicited, or transferred drugs while working or while on the employer's premises or while operating the employer's vehicle, machinery, or equipment. Follow-up - Upon return to work from a drug alcohol treatment program or upon return from an extended absence. Routine Fitness for Duty - Upon routine medical examination when it becomes a part of established procedure. Random Selection - As part of a random unannounced drug testing program conducted through the use of a random number generator or other neutral selection process whereby employees in "High Risk Positions" will be randomly selected for drug testing.
Description In First Shot, John Craddock investigates a little-known but clear eleventh-hour warning that, had it been heeded, might have enabled the Navy's Pearl Harbour command to blunt the Japanese assault and save ships and lives. Craddock reveals that the attack plan of Japan's Admiral Yamamoto included five midget submarines, each carrying two men and two torpedoes. First Shot vividly recreates the action on the deck of the U.S.S. Ward on the morning of December 7 as the outmoded relic of an earlier war engaged a tiny, state-of-the-art undersea fighting machine. Table of contents Prologue 1 The Samurai's Son 2 The Smallest Subs 3 The First Shot 4 The First Prisoner of War 5 Deadly Distractions and the Battle of Midway 6 The Assassination 7 The Suicide Squads 8 The War without End 9 The Puzzle Epilogue Notes Bibliography Acknowledgements Index.
