Adults diagnosed with schizophrenia smoke cigarettes at excessive rates. The goal of this study was harm reduction by reducing carbon monoxide (CO) levels for 9 adults diagnosed with schizophrenia living in a semi-independent apartment complex. The participants were randomly assigned to one of three groups: Contingent monetary reinforcement (CMR), feedback, and CMR used in combination with feedback. CMR and feedback group was hypothesized to exceed the results of CMR alone and of feedback alone. CO levels were collected once a day for 4 weeks. Individualized CO reduction criteria were developed based on baseline mean CO levels. It was also hypothesized the addition of feedback would lend itself to better maintenance and generalization. Data were analyzed through visual inspection. Results suggested that CMR plus feedback does not improve the effectiveness of CMR alone to maintain reductions in CO levels for adults diagnosed with schizophrenia. Important findings from this study can help alleviate problems for future smoking reduction programs that serve this population.

The purpose of this study was to design, evaluate, and determine the cost benefit of a pharmacokinetic service for home-based patients. Four randomly selected patient populations were used in evaluating the service for six months. The experimental group consisted of 17 patients who were under the care of family practice physicians in private practice and who received pharmacokinetic consultation and monitoring by a pharmacist as a home health care service. The retrospective control consisted of the same 17 patients of the experimental group whose past medical history for a period of six months was used. The concurrent control consisted of 17 patients who were concurrently treated by the same family practice physicians in private practice who treated the patients in the experimental group. The fourth group consisted of 17 patients who were concurrently treated by family practice physicians in a general hospital outpatient clinic. The service was evaluated by comparing the following variables: serum levels ordered, serum levels ordered inappropriately, physicians' office visits, hospitalizations secondary to pulmonary problems, and emergency room visits secondary to pulmonary problems. A one-way analysis of variance, Scheffe's post hoc test, and t test were used to analyze the results. There was a significant difference (P greater than 0.05) in the number of inappropriate levels ordered, physician's office visits, and emergency room visits. The cost of the service was $134 and the benefit was $218. It was concluded that a homebased pharmacokinetic service is cost beneficial in this patient population.

This research project was designed to test whether the in vitro percutaneous penetration of benzocaine through human cadaver skin could be enhanced by dimethyl sulfoxide (DMSO), urea, polyoxyethylene (20) isohexadecyl ether and 1-dodecylazacycloheptan-2-one (Azone) in propylene glycol/water systems. Solubility and partitioning of benzocaine in propylene glycol/water systems was investigated. The adjuvant effects were studied in a 60/40 (V/V) propylene glycol/water co-solvent system. The well known drug penetration enhancer dimethyl sulfoxide did not enhance the penetration of benzocaine at any concentration level of DMSO under the conditions of the experiment. This lack of enhancement effect was probably due to increased solubility of benzocaine in the DMSO/water system and a consequent decrease in the partitioning of drug into the skin. Urea enhanced benzocaine penetration initially but no significant steady-state penetration enhancement was noted. Polyoxyethylene (20) isohexadecyl ether appeared to retard rather than enhance the percutaneous penetration of benzocaine at concentrations below and around the critical micelle concentration. Azone showed concentration dependence for its enhancement effect on penetration of benzocaine. With 1% V/V Azone, the initial benzocaine penetration rate was higher compared to the other Azone concentrations. On the basis of comparative analysis of the steady-state rates, 5% V/V Azone was observed to be the most effective penetration enhancer for benzocaine. Azone also showed additive enhancement properties with increasing percentages of propylene glycol. The results of this investigation emphasize the importance of in vitro skin penetration studies prior to clinical evaluation. The results also underscore the importance of a proper experimental design that will minimize variables during the study in order to properly identify cause and effect relationships.

There is growing research suggesting that individuals diagnosed with schizophrenia are impaired in their ability to recognize and express facial emotions. However, research examining the effects of treatment on facial emotion expression and recognition deficits is extremely limited. This study examined the effects of a brief training program on the ability to express and recognize facial emotions among individuals diagnosed with schizophrenia ( N = 6). Assessment procedures included identification (photo and in vivo models), imitation, and simulation. The training program consisted of 8 sessions, lasting approximately 20–30 min. The first training session consisted of a discussion about the six basic emotions (happy, sad, surprised, fearful, angry, disgusted). The next seven training sessions included identification (photo and in vivo models), imitation, and simulation of each of the six basic emotions. Verbal reinforcement and feedback were used to increase performance. The results indicated that performance improved for all tasks from baseline to treatment, and maintained during a 3-week follow up period.

The efficacy of risperidone (Risperdal) for the treatment of 3 chronically aggressive children was evaluated using an open-label, multiple-baseline design in a private practice setting. Results of both parent and teacher ratings demonstrated a reduction in aggressive and delinquent behavior in 2 of 3 participants upon introduction of Risperdal, with the third responding in similar fashion upon final dose adjustment. Each participant reported no occurrences of side effects. These findings suggest that Risperdal was well tolerated, and may serve as a safe and effective treatment modality for this challenging population.

Over the last 30 years, organ transplantation has become a common life saving surgery. However, organ transplantation is still limited by a lack of viable organs due to the small number of individuals who sign a donor card or agree to donate their next-of-kin's organs. What has been found to be effective to increase donation rates is to bring donation “closer to home” by using public awareness campaigns, and by increasing the emotional connect between the donor and the recipient. The current study attempted to increase the emotional connection between the donor and the recipient by providing the donor family with general, anonymous demographic information about potential recipients at the time of the request for a next-of-kin's organs. Both the control group ( N = 169) and the experimental group ( N = 162) viewed an educational video about organ donation, followed by a dramatization of an organ procurement coordinator requesting participants to donate their next-of-kin's organs. The dramatization for the experimental group contained general, anonymous demographic information (e.g., age, gender, number of children) about potential recipients. The control group dramatization did not contain any demographic information about potential recipients, which is similar to the actual request process currently used by the organ procurement coordinators. As hypothesized, providing general, anonymous demographic information about potential recipients increased the willingness of the donor family to donate their next-of-kin's organs as measured by a significantly higher score on the experimental group's Willingness to Donate a Next of Kin's Organs Survey. Furthermore, providing recipient information also increased the willingness for the participants of this study to take action towards becoming organ donors. Finally, both groups showed an increase in knowledge about organ donation as well as an increase in positive attitudes and a decrease in negative attitudes toward organ donation. The implications of these results are discussed.

Heart failure in its simplest terms can be defined as the inability of the heart to pump blood in adequate amounts to maintain circulation. A more descriptive definition of HF is a complex clinical syndrome, where the myocardium is unable to pump sufficient amounts of blood to supply the metabolic needs of the body which may be characterized by dyspnea, fatigue, effort intolerance, and decreased survival. Data from the recent heart disease and stroke statistics update from the American Heart Association has startling implications. The overall prevalence of total cardiovascular disease in the United States is 79.4 million individuals. While the prevalence of heart failure only encompasses 2.5% of the overall total, heart failure affects 57.7 thousand Americans. It is interesting to note that the prevalence of heart failure is equally distributed among men and women. In the past, it was thought of a disease that mostly affected men. The cost of treatment of heart failure is staggering. Since 1979 there has been an overall increase in heart failure hospital discharges of 175 percent. In 2007 it is estimated that the total cost of heart failure is $33.2 billion in the United States. Based on these estimates, the Evaluation of Heart Failure Clinic Alternative - Clinician Effectiveness Study was begun at San Joaquin General Hospital.

Idiopathic Scoliosis, IS, affects only about 5% of the population but can produce very disabling deformities, affecting other major systems in the body. The most commonly affected are young females between the ages of 8 and 16 years of age. The specific cause of IS is unknown but it is hypothesized to be a multisystem disorder. The purpose of this descriptive study was to measure the neuromuscular factors of joint laxity, muscle strength, and sensory processing in female adolescents (N = 90), 46 who were being treated for IS and 44 age matched controls who were screened for scoliosis and found to have no spinal curves. Based on the analysis of variance of the subjects with IS, the experimental group had significantly more joint laxity at the knee and elbow (p $\le$ 0.0001) as well as tactile defensiveness (p $\le$ 0.0001) and tested weaker in quadriceps femoris strength (p $\le$ 0.003 and p $\le$ 0.008) left and right respectfully. Those with IS were more likely to have a history of difficult births (42% vs. 28%). Those with difficult births were more likely to have larger thoracic curves (p $\le$ 0.013), greater weakness in the left quadriceps (p $\le$ 0.0015) and greater tactile defensiveness (p $\le$ 0.0437). The findings in this study confirm the presence of neuromuscular skeletal difficulties. It is conceivable that joint laxity is related to difficulty in sensory processing and reduced postural tone that impairs postural righting against gravity. It is not clear if these imbalances can be remediated. Further studies on postural righting and stabilization along with EMG analysis during functional activities could clarify what intervention strategies might be used to provide the stability necessary to prevent further curve progression or improve the spinal alignment.

No description available.

In addition to their potential value for in situ bioremediation, the earthworm as a laboratory model may offer insight into mechanisms of xenobiotic toxicity. Using the filter paper contact toxicity test, the LD50s of a series of salicylates and phenolics were determined. The rank order in toxicity of these chemicals was compared with mammalian (rat, oral dosing) LD50s and found to be similar. To determine if protein secretion from chemical stress would be a more sensitive toxicity marker for the above xenobiotics, worms were exposed to either sodium salicylate or acetaminophen at a no effect level (NOAEL) and at the LD100 through filter paper contact. The ability of L. terrestris to metabolize drugs was investigated by using worm homogenate to treat various drugs in both encapsulated and free enzyme forms.