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71.
Atallah R Nehmé C Séoud J Yérétzian J Zablit C Lévesque L Ducharme F 《Recherche en soins infirmiers》2005,(81):122-138
The primary objective of this pan Lebanese study was to describe the health care context of family caregivers cohabiting with an elderly relative with loss of autonomy while the secondary objective consisted in the qualitative documentation of their positive and negative perceptions as to the role of the caregivers. The study uses a theoretical framework of stress. The results indicate that the caregivers (N = 319) take care of relatives (40% with memory troubles) having a moderate level of loss of autonomy and who present more depressive behaviors than "disturbing" behaviors. The caregivers are particularly affected by the behaviors of their relatives. They accomplish several health care tasks and very few receive formal services to support them. Their neighborhood offers them more emotional support than instrumental support. More caregivers perceive positive aspects than negative aspects in their role. Recommendations are formulated to guide the elaboration of a national policy of support to caregivers and the development of innovative community care practices. 相似文献
72.
Maat M Buysse CM Emonts M Spanjaard L Joosten KF de Groot R Hazelzet JA 《Critical care (London, England)》2007,11(5):R112
Background
To gain insight into factors that might affect results of future case-control studies, we performed an analysis of children with sepsis and purpura admitted to the paediatric intensive care unit (PICU) of Erasmus MC-Sophia Children's Hospital (Rotterdam, The Netherlands). 相似文献73.
Edwards DJ Fitzsimmons ME Schuetz EG Yasuda K Ducharme MP Warbasse LH Woster PM Schuetz JD Watkins P 《Clinical pharmacology and therapeutics》1999,65(3):237-244
BACKGROUND: 6',7'-Dihydroxybergamottin is a furanocoumarin that inhibits CYP3A4 and is found in grapefruit juice and Seville orange juice. Grapefruit juice increases the oral bioavailability of many CYP3A4 substrates, including cyclosporine (INN, ciclosporin), but intestinal P-glycoprotein may be a more important determinant of cyclosporine availability. OBJECTIVES: To evaluate the contribution of 6',7'-dihydroxybergamottin to the effects of grapefruit juice on cyclosporine disposition and to assess the role of CYP3A4 versus P-glycoprotein in this interaction. METHODS: The disposition of oral cyclosporine was compared in healthy subjects after ingestion of water, grapefruit juice, and Seville orange juice. Enterocyte concentrations of CYP3A4 were measured in 2 individuals before and after treatment with Seville orange juice. The effect of 6',7'-dihydroxybergamottin on P-glycoprotein was assessed in vitro. RESULTS: Area under the whole blood concentration-time curve and peak concentration of cyclosporine were increased by 55% and 35%, respectively, with grapefruit juice (P < .05). Seville orange juice had no influence on cyclosporine disposition but reduced enterocyte concentrations of CYP3A4 by an average of 40%. 6',7'-Dihydroxybergamottin did not inhibit P-glycoprotein at concentrations up to 50 micromol/L. CONCLUSIONS: 6',7'-Dihydroxybergamottin is not responsible for the effects of grapefruit juice on cyclosporine. Because the interaction did not occur with Seville orange juice despite reduced enterocyte concentrations of CYP3A4, inhibition of P-glycoprotein activity by other compounds in grapefruit juice may be responsible. Reduced enterocyte CYP3A4 by 6',7'-dihydroxybergamottin could be important for other drugs whose bioavailability is less dependent on P-glycoprotein. 相似文献
74.
Ducharme LJ Knudsen HK Abraham AJ Roman PM 《The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions》2010,19(6):496-503
Counselor attitudes toward evidence-based practices, such as motivational incentives/contingency management (MI/CM), are important in bridging the gap between research and practice. Mailed surveys from 1,959 substance abuse treatment counselors showed ambivalence toward MI/CM and strong disagreement with using monetary rewards for achievement of treatment goals. Attitudes were associated with counselors' educational attainment, a 12-step treatment ideology, affiliation with NIDA's Clinical Trials Network, and working in opioid treatment programs. Exposure to MI/CM via training was more strongly associated with attitudes when counselors worked in programs that had adopted MI/CM. While there is substantial resistance to MI/CM, dissemination and training about the essential elements of MI/CM may enhance counselors' receptivity toward this intervention. 相似文献
75.
76.
Chen ML Shah VP Crommelin DJ Shargel L Bashaw D Bhatti M Blume H Dressman J Ducharme M Fackler P Hyslop T Lutter L Morais J Ormsby E Thomas S Tsang YC Velagapudi R Yu LX 《European journal of pharmaceutical sciences》2011,44(4):506-513
Regulatory approaches for evaluating therapeutic equivalence of multisource (or generic) drug products vary among different countries and/or regions. Harmonization of these approaches may decrease the number of in vivo bioequivalence studies and avoid unnecessary drug exposure to humans. Global harmonization for regulatory requirements may be promoted by a better understanding of factors underlying product performance and expectations from different regulatory authorities. This workshop provided an opportunity for pharmaceutical scientists from academia, industry and regulatory agencies to have open discussions on current regulatory issues and industry practices, facilitating harmonization of regulatory approaches for establishing therapeutic equivalence and interchangeability of multisource drug products. 相似文献
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79.
Magda Wullink Wemke Veldhuijzen Henny MJ van Schrojenstein Lantman - de Valk Job FM Metsemakers Geert-Jan Dinant 《BMC family practice》2009,10(1):1-10
Background
Patients' priorities and views on quality care are well-documented in Western countries but there is a dearth of research in this area in the East. The aim of the present study was to explore Chinese patients' views on quality of primary care consultations in Hong Kong and to compare these with the items in the CARE measure (a process measure of consultation quality widely used in the UK) in order to assess the potential utility of the CARE measure in a Chinese population.Methods
Individual semi-structured interviews were conducted on 21 adult patients from 3 different primary care clinics (a public primary healthcare clinic, a University health centre, and a private family physician's clinic). Topics discussed included expectations, experiences, and views about quality of medical consultations. Interviews were typed verbatim, and a thematic approach was taken to identify key issues. These identified issues were then compared with the ten CARE measure items, using a CARE framework: Connecting (Care Measure items 1–3), Assessing (item 4), Responding (items 5,6), and Empowering (items 7–10).Results
Patients judged doctors in terms of both the process of the consultation and the perceived outcomes. Themes identified that related to the interpersonal process of the consultation fitted well under the CARE framework; Connecting and communicating (18/21 patients), Assessing holistically (10/21 patients), Responding (18/21 patients) and Empowering (19/21 patients). Patients from the public clinic, who were generally of lower socio-economic status, were least likely to expect holistic care or empowerment. Two-thirds of patients also judged doctors on whether they performed an adequate physical examination, and three-quarters on the later outcomes of consultation (in terms of relief or cure and/or side-effects of prescribed drugs).Conclusion
These findings suggest that Chinese patients in Hong Kong value engaged, empathic primary care doctors and judge the quality of consultations largely on these human skills and the attitudes and values that underpin them, as well as on the perceived outcomes of treatment. The match between themes relating to consultation process and the CARE Measure items suggests utility of this measure in this population, but further quantitative validation is required. 相似文献80.