Increase economic opportunities and give the Cuban people hope for an economic stake in the new system. Quick and visible economic progress will give important legitimacy to the Cuban Transition Government. A Cuban Transition Government will face critical issues ranging from stabilizing the Cuban macroeconomic condition to creating a microeconomic framework that will allow private enterprise to grow. It will confront a long history of poor labor relations and demands to respect the rights of workers to form unions and bargain collectively. It will need to ensure that its critical infrastructure is not only adequately functioning, but on the road to recovery and keeping pace with the demands of a growing, free economy. In addition, other actors, including Cubans abroad, the international community, and the U.S. Government, will have an important role to play in responding to requests from the Cuban Transition Government for support and advice. We need to prepare now to maximize the benefit each of these actors can bring to the table at a key moment in Cuban history. Should a Cuban Transition Government request United States assistance in its economic transition, the U.S. Government can provide help in establishing macroeconomic stability; reintegrating Cuba to the international trade and financial systems; encouraging small business development; ensuring labor rights are respected; stabilizing existing Cuban agricultural capability and local markets; and improving broad-based access to and accountability for sustainable essential infrastructure. THE ROLE OF THE INTERNATIONAL COMMUNITY The international community will be instrumental in assisting a Cuban Transition Government that guarantees political freedom, economic opportunity and holds free and fair elections. Support from the international community will also help accelerate Cuba's reintegration into the world economy, bring useful experiences to bear from other countries that have succeeded in transitions, and ease the humanitarian and financial burden on the Cuban Transition Government. The United States and its neighbors have committed to representative democracy as the standard for the Inter-American system and have an obligation under the Inter-American Democratic Charter to support and defend democracy and all that it represents. These commitments will guide our approach to a transitional Cuba. If the Cuban Transition Government requests help, the U.S.
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BALLOT MEASURE SUMMARY Prepared by the Legislative Affairs Agency Provides that a person 21 years of age or older may not face civil or criminal penalties in most cases that relate to their having, using, providing, and making hemp. Provides that a person 21 years of age or older may not be required to get a permit to use hemp in most cases. Defines hemp as marijuana and all forms of the cannabis plant. Defines other terms that relate to hemp. Allows laws that restrict persons less than 21 years of age from having hemp intoxicating products. Allows laws that restrict persons less than 21 years of age from the use of hemp intoxicating products. Allows laws that restrict the sale or transfer of hemp intoxicating products to persons less than 21 years of age. Allows laws that limit the use of hemp intoxicating products and the operation of motor vehicles. Allows laws that limit the use of hemp intoxicating products and engaging in conduct that affects public safety. Allows laws that limit the use of hemp intoxicating products in a public place. Allows a physician to prescribe hemp to a patient. Restricts laws that place special limits or fees on the makers of hemp medicines. Restricts laws that place special limits or fees on the makers of hemp nutritional products. Restricts laws that place special limits or fees on the makers of hemp industrial products and
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A first aid register is readily available for inspection by the committee or representative; and is under the charge of a first aid attendant with the qualifications required by this Part who is readily available to provide first aid; and is used exclusively for the purposes of administering first aid and medical examinations and to provide rest for persons who are injured or ill. 4 Oct 96 c0-1.1 Reg 1 s58.
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14. Dial S, et al. CMAJ 2004; 171: 338. Muto CA, et al. Infect Control Hosp Epidemiol 2005; 26: 27380. Thomas C, et al. Clin Infect Dis 2002; 35: 145762. Martin RM, et al. Br J Clin Pharmacol 2000; 50: 36672. Claessens AA, et al. Pharmacoepidemiol Drug Saf 2002; 11: 7038. Hilmer SN, et al. Med J Aust 2006; 184: 1856. Adverse Drug Reactions Advisory Committee. Aust Adv Drug React Bull 2003; 22: 7. Geevasinga N, et al. Med J Aust 2005; 182: 2356. Geevasinga N, et al. Proton pump inhibitors: the most common iatrogenic cause of acute interstitial nephritis? RACP ASM 2005. : racp .au asm asm2005 abstract book accessed 27 March 2006 and
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DECLARATIVE I. Public health principles relative to infectious communicable ; diseases A. Infectious diseases affect entire populations of humans B. Important to understand the demographic characteristics of the population C. The relationships between populations is important when studying the dynamics of infectious diseases D. The study of an infectious disease cluster a discrete population which is infected in a defined span of time in a defined geographical area ; is, by its nature, regional; however, the consequences of that cluster becoming infected may be international E. Populations display varying susceptibilities to infection, and conversely, varying degrees of susceptibility F. When dealing with infectious diseases, the paramedic needs to consider the needs of the patient and the potential consequence on public health G. Paramedics should think of the consequences of their person-to-person contacts with family members and friends Public health agencies involved in the prevention management of disease outbreaks A. Local municipal, city, county ; health agencies 1. First line of defense in disease surveillance 2. First line of defense in disease outbreaks B. State agencies 1. Frequently involved in regulation and enforcement of federal guidelines 2. They frequently are, by statute or public law, obliged to meet or exceed federal guidelines and recommendations C. Private sector 1. Regional and national health care providers and local and national health maintenance organizations 2. Influence protocols and guidelines for dealing with disease surveillance response to outbreaks D. Federal and national organizations 1. U.S. Congress plays an integral role in national health policy through public laws and by drafting of the federal budget 2. U.S. Department of Labor a. Occupational Safety and Health Administration OSHA ; 3. U.S. Department of Health and Human Services 1 ; Centers for Disease Control 2 ; National Institute for Occupational Safety and Health NIOSH ; 4. U.S. Department of Defense and Federal Emergency Management Agency FEMA ; 5. National Fire Protection Association NFPA ; , U.S. Fire Protection Administration and International Association of Firefighters IAFF ; Infection, pathogenicity, and infectious agents A. Steps of infectious process 1. Infectious agent resident in reservoir animal, man, environment ; 2. Infectious agent may be present in the ecosystem, affected by a. Life-cycle of the infectious agent b. Environmental factors which dictate presence of endemic species outside of the host c. Climatic conditions, for example, propulsid lawsuit.
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IN ATTENDANCE Mr S Bryson Mr R Foot Mrs Y Semple Mrs E Watt . Pharmaceutical Adviser, NHS Greater Glasgow Formulary Development Pharmacist, Glasgow Royal Infirmary Principal Pharmacist, Clinical Effectiveness Secretariat ACTION BY 60. APOLOGIES Apologies for absence were intimated on behalf of Dr P Beardon, Dr J Burns, Mr A Crawford, Dr J Gravil, Mr S Hill, Dr I Matson, Mrs L McGovern, Mrs M Ryan, Mr D Thomson and Dr I Wallace. 61. MINUTES The Minutes of the meeting of the Area Drugs and Therapeutics Committee held on 28 August 2006 [ADTC M ; 06 4] were approved as a correct record. NOTED.
Table D1.5. Blocks used in the CPFV CPUE analysis see Figure D1.17 for area definitions and
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NURSE SATISFACTION WITH PALLIATIVE CARE CLINICAL PHARMACIST SERVICES Justin Kullgren * , Phyllis A. Grauer, Jason Kimbrel, Bridget McCrate Protus The Ohio State University College of Pharmacy, 7605 Apt A Mill Bench Ct, Dublin, oh, 43016 kullgren.2 osu Purpose: Specialized palliative care pharmacists provide a host of clinical services to the interdisciplinary team involved in the management of hospice patients. To date one study has been conducted assessing the quality of pharmaceutical services provided to hospice programs in Columbus, Ohio. This study was published in 1996, and included 25 nurses from three local hospice programs in Columbus. Services provided by palliative care clinical pharmacists have evolved since the last survey and now encompass many more hospices across the United States. Thus, this survey will include a larger sample size and provide input from hospice nurses across the United States Methods: A non-randomized online survey of nurses working for hospice programs that contract with Palliative Care Consulting Group, a palliative care clinical pharmacist consulting service. Nursing administrators from the contracted hospices will provide the list of nurses to be surveyed. The final survey will be conducted during February 2007 using the online tool, Zoomerang. Participants will be incentivized to complete the survey. The survey consists of Likert-style, multiple choice, and open-ended questions. All of the data collected will be recorded without patient identification to maintain confidentiality. Questions include nurse demographics, satisfaction with services provided, and perceived value of clinical pharmacist services. Data analysis will be conducted using SPSS statistical software. Prior to distribution of the survey, the project will be approved by an Institutional Review Board. Results Conclusion: Preliminary results to be presented at Great Lakes Pharmacy Resident Conference. Learning Objectives: Define the role of a palliative care pharmacist in the management of hospice patients. Review a methodology to assess the satisfaction of clinical pharmacy services. Self Assessment Questions: True False: Medicare mandates that a pharmacist sit on the interdisciplinary team that reviews hospice patients. List three services that a palliative care pharmacist provides to hospices and
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Mental health team will make sure they know about your needs, and plan your treatment in detail with you. They should develop a care plan based upon an assessment of all your social, work, accommodation, financial, medical, psychological and cultural needs. If you don't see your GP or don't wish to, your psychiatrists could also do regular physical checks with you they'll let your GP know that they are doing so. Your care co-ordinator and mental health team should decide with you how often these full assessments need to be done and write this in your notes. If you are on `enhanced CPA' usually because you need a lot of help ; you may have full assessments every year. Your carers family can play an important part in helping your recovery. They also need help, especially in times of crisis. If you agree, the team who help you should contact your carers and provide information, support and develop a carer care plan to record the help they need. The teams that will help, now and in the future At the moment, most help will come from your community mental health team CMHT for short ; . This will continue to be the case in Wales. However, in England other teams are being developed to give you extra help should you need it. For example, if you have had several breakdowns, have been on the wards a lot, have poor housing or are homeless, you should have and clemastine.
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While there is evidence that cyclophosphamide or chlorambucil can induce remission of proteinuria in some cases of membranous nephropathy and nephrotic syndrome, the data is confounded by the inclusion in trials of patients who may have had spontaneous remission as well as by differences in study methodology. There is also currently insufficient evidence to demonstrate any benefit in terms of progressive renal impairment and ESKD. The optimal agent to use remains to be established. Nonetheless, in patients with poor prognostic features, such as heavy proteinuria 3 g 24 impaired renal function at presentation, deteriorating renal function in whom after a period of monitoring, an inexorable decline in renal function appears likely, the possibility of inducing remission of proteinuria by using cytotoxic therapy should be balanced against the significant risk of toxicity.
Soluble base instead of the more conventional hydrogenated vegetable oil, can be effective for some people. Another product Ceo-Two, initiates a chemical reaction that releases carbon dioxide to stimulate a rectal anal reflex Linsenmeyer and Stone, 1998 ; . These products are available by mail order or from some pharmacies see Appendix ; . The Theravac Mini-enema has been demonstrated to improve bowel emptying and reduce evacuation time in the spinal cord injured population Dunn and Galka, 1994 ; . This is a capsule just a little larger than a suppository, containing liquid bisacodyl in a polyethylene glycol base, which is squeezed into the rectum. One drawback of these products is that they are quite expensive, and as non-prescription items, they are not typically covered by most health insurance plans or by Medicaid. Most authorities caution against the regular long-term use of oral laxatives Holland, 1999 ; , but in practice they may be difficult to avoid in neurogenic bowel, even in the early stages. Over the years, the rectum and distal colon typically become distended, and intestinal motility may become increasingly sluggish, necessitating the use of agents such as senna or oral bisacodyl. The administration of these should be timed so that their onset coincides with the bowel training program typically 8 hours prior ; . Changes in the regime should be introduced cautiously, implementing one modification at a time, and allowing several days or even a couple of weeks to monitor response to each intervention. Individual tolerance varies greatly, and the occurrence of side effects such as bloating, cramping or flatulence should be managed empirically by trial of the various agents available. The regular use of enemas is not recommended, as they can contribute to further distension. Their use should be reserved for the treatment of impaction see below ; . Some clinicians have used prokinetic agents such as Cisapride Propulsid ; or Metoclopramide for patients with difficult, sluggish neurogenic bowels Tan, 1998 ; , but there are many concerns about side effects, and Cisapride is now on a limited access protocol. Perhaps some safer prokinetic agents will become available in the future. Some people with long-standing spinal cord injury or multiple sclerosis may have established routines where they perform their bowel training program only once every four or five days or even less frequently. This may seem convenient, but it is not to be recommended. Current thinking is that this is probably a key factor in the development of an overdistended rectum and colon, and the progressive lack of response to bowel interventions as the decompensated rectum cannot generate sufficient expulsive force Consortium for Spinal Medicine, 1998, Linsenmeyer and Stone, 1998 ; . While it may be very difficult both psychologically and physiologically to change long-established patterns, those with more recent onset should be encouraged to maintain a bowel training program at least every other day. Maintaining a consistent regular diet without extreme fluctuations in the intake of fibrous or stimulant foods is also important for a successful bowel training program. Episodes of overindulgence of spicy foods or summer fruit, while causing just a minor inconvenience for most people, are likely to be disastrous for those without voluntary control of the anal sphincter, leading to embarrassing accidents and potentially skin breakdown in the perineal area. Stool consistency is a key factor for success, and many clients will have empirically discovered certain foods or combinations to avoid. Some women find that their bowels are well controlled except around the time of their menstrual period, or that modifications to their diet or bowel stimulants are required at that time of the month. Women with lower motor neuron lesions, as in spina bifida or cauda equina injuries, where the anal sphincter typically becomes totally flaccid, face special challenges. The.
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Medication and Enteral Feeding Page 7 of 20 Prepared by Sandra Martin - Senior Pharmacist, Rachael Davidson - Senior Dietitian, Dave Holland Senior Speech and Language Therapist Approved by Medicines Management Committee . February 2004 Review Date . February 2006.
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Table 12 shows the Other responses and ratings. Table 12: Other POSITIVE characteristics Characteristic.
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25 mg kg sulfa 1.25 By weight: Known sulfa 0.12 mg kg pyrimethamine 25 mg kg sulfa 1.25 allergy per kg as single dose. mg kg pyrimethamine SL: 65 per kg as single dose: Average adult: P: 80100 1500 mg sulfa 75 mg By age: pyrimethamine as 1 year: 1 2 tablet single dose. 13 years: 3 4 tablet 48 years: 1 tablet Equivalent to 3 tablets 914 years: 2 tablets as a single dose. ; 14 years: 3 tablets Treatment: 750 mg base to 1500 mg base depending on local resistance patterns. Larger doses 15 mg kg ; best given in split doses over 2 days. Prophylaxis: 250 mg once per week. Treatment: 15 mg Known 1.92 base ; kg to 25 mg or suspected base ; kg depending history of on local resistance neuropatterns. Larger doses psychiatric 15 mg kg ; best disorder. given in split doses history of over 2 days. seizures concomitant Prophylaxis: 5 mg use of base kg once per halofantrine. week.
| Propulsid without prescriptionJune 27, 2000 personal health; traveler's tricks for riding out the waves of motion sickness by jane brody i've known since childhood that i was susceptible to motion sickness.
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It's estimated that 350, 000 americans were taking propulsid at the time it was removed from the general market.
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