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Minibag Total Volume After Additives POSTED ON 11 10 2004 For hospitals that mix medications in minibags for nursing, do you print on the label the ACTUAL total volume in the bag? Example: If you add 2 grams cefazolin to a 50mL bag, do you report the final volume as 60mL 50mL for bag and 10mL for cefazolin additive ; ? I understand that the 50mL bag probably has overfill as well! ; The reason I ask is as we move to more medications being administered via a pump instead of gravity, if 50mL is programmed in as the final volume, some dose may be left in the bag? Thanks Kristen Thorson Cl Supervisor PinnacleHealth Hospitals HBG, PA kthorson PINNACLEHEALTH At Hershey Medical Center, we do not include the volume of the additives. Ronald E. Lay, M.S., R.Ph. Pharmacy Supervisor Penn State Milton S Hershey Medical Center Hershey PA rlay psu At present, we usually do account for diluent and overfill, although for some critical care meds we do. Matt Levanda MLevanda bchs Kristen: No, we do not do this. This is one reason why I want to go to 100ml volume as our standard for adult IVPBs obviously, there will be fluid restrictions orders, drug concentration requirements, etc ; . Because it's not just the volume contribution of the additive, it's the significant amount of drug remaining in the IV tubing in our case, approx 15 ml so for our current standard of 50ml volume, often 30 % of the dose is not infused ; . I think your major residual dose will be in the tubing in most cases. Steve Stephens, RPh Manager, Pharmacy Operations Memorial Medical Center Springfield, Illinois stephens ephen mhsil We do not include the volume of the additives a Vanderbilt Medical Center. Sheree Foster.
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2. Congruence: therapist must be unique, integrated, and congruent; must be in the relationship exactly as he she is, not only a "role" or a "mask". 3. Unconditional positive consideration: it is about a total acceptation of the person's feelings and expressions, without judgment or prejudice. 4. Empathic comprehension: to notice the client's interior world as it was your own, but not making confusion about being yours in deed. 5. Transmission: client must notice minimally the congruence, acceptation and empathic comprehension from therapist. As I have discussed before, I believe that a horse, in certain way, has all the characteristics above, but, even it has a unique and unquestionable role in that therapy, the one that is supposed to establish the relation between person and horse is the Therapeutic Riding Instructor, and I ask: `Can the equine therapist promote the basic conditions congruence, unconditional acceptation, empathy and transmission?' When Rogers identified such conditions he was probably unconcerned about Therapeutic Riding. I risk imagining that if he were in a Therapeutic Riding setting, he would add the condition: `To establish the contact between person and horse preserving the client's emotional and physical integrity'. Although all the conditions above are important, we focus in the mediator's responsibility to form an intensive, real and safe contact between person and horse, for emotional and physical matters.
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Table 3 Mean S.E.M. ; activity counts during conditioning days Vehicle day 1 Amph 20.0 ; NPC 0.1 ; + amph NPC 0.5 ; + amph NPC 1.0 ; + amph NPC 1.0 ; alone 279.7 259.6 312.5 ; 35.1 ; 35.9 ; 24.9 ; 36.6 ; 2 291.6 228.7 ; 27.0 ; 28.9 ; 28.0 ; 21.1 ; 3 272.7 202.7 ; 33.4 ; 40.0 ; 29.9 ; 39.7 ; 4 279.6 299.0 ; 37.2 ; 34.7 ; 35.2 ; 23.9 ; Mean 280.9 247.5 280.7 ; 33.2 ; 34.9 ; 29.5 ; 30.3 ; Drug day 1 924.9 914.7 ; 61.1 ; 102.3 ; 38.4 ; 34.5 ; 2 945.6 894.1 ; 67.8 ; 77.0 ; 33.5 ; 43.72 ; 3 987.1 994.0 ; 28.3 ; 64.8 ; 41.4 ; 19.8 ; 4 943.4 861.9 ; 44.4 ; 30.8 ; 79.0 ; 35.7 ; Mean 950.3a 36.7 ; 915.2a 50.4 ; 986.8a 68.7 ; 937.9a 48.1 ; 293.3 33.4, for example, candesartan cilexetil side effects.
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Rity. At the time I was going to Dr. Money's clinic I never really understood why I was going, until just before they released me. Still, I had no hard feelings toward this clinic. It was Dr. Money's clinic that referred me to a psychiatrist, Dr. Lowden. My parents brought me to her for quite a few years. I feel I would have been better off if I had never gone; actually I feel damage was done. She made me feel inferior, and that everything was my fault. I was so glad when my parents stopped taking me to her. I was also brought to an institute for children with learning disabilities. They tested me and found that I had dyslexia, but I was just above their enrollment standards, so they refused to admit me. Every year my parents, who thought I was retarded, would have me tested at that institute, and every year I would score just high enough not to be enrolled. After a major surgery I was not well enough to attend school, and had a home tutor. He taught me how to read, write, and spell, and got me out of having to go to the learning disabilities institute every year for testing. This brings me to my bad attitude toward Dr. Lowden. After eight years of going through school not being able to read, suddenly I could. But she thought it no big deal, and said that my tutor had overrated my progress. She had the test to prove it. To this, I have two things to say. 1 ; Fuck you, Dr. Lowden. 2 ; The reason she belittled my progress under my tutor was because she tried to teach me to read and could not. That pretty much sums up me and the medical community. I have one question, though, for other ISNA members. As a sexually intermediate person, have you ever encountered a psychiatrist who was helpful and not hurtful? Sincerely, T and clozapine.
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Some opportunistic infections involve the mouth and throat, causing barriers to adequate nutrition, which is essential for maintenance of the health of HIV AIDS patients. Contact your health care provider at the sign of any unfamiliar symptoms. Refer to Table 2 for specific problems and recommended nutritional care. Keep mouth clean by rinsing it with a dilute solution of hydrogen peroxide and water, or a solution recommended by your dentist, at least three times a day, especially after eating. Do not swallow the solution. Try warm salt-water rinses to soothe. Dental care is important--rinse or brush after every meal and snack if possible. A soft bristle toothbrush is a good choice. If you still experience pain or bleeding, try using a cotton swab instead. Everyone should floss daily unless it is painful or causes the gums to bleed excessively. Avoid water-shooting devices and commercial mouthwashes that contain alcohol. Talk to your dentist to get recommendations on oral hygiene options that are right for you. Don't eat foods at extreme temperatures. Eat foods that are soft, like mashed potatoes, scrambled eggs, grits, cream soup, cream of wheat, canned or cooked fruits, noodles or pasta, cottage.
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Net Investment Hedging We hedge certain net investment positions in major foreign subsidiaries. To accomplish this, we either borrow directly in foreign currency and designate all or a portion of foreign currency debt as a hedge of the applicable net investment position or enter into foreign currency swaps that are designated as hedges of our related foreign net investments. Under SFAS 133, changes in the fair value of these instruments are immediately recognized in other comprehensive income, to offset the change in the value of the net investment being hedged. Currency effects of these hedges reflected in other comprehensive income were a $786 after-tax loss, a $135 after-tax gain and a $348 after-tax loss in 2006, 2005 and 2004, respectively. Accumulated net balances were $1, 237 and $451 after-tax losses in 2006 and 2005, respectively. Commodity Price Management Certain raw materials utilized in our products or production processes are subject to price volatility caused by weather, supply conditions, political and economic variables and other unpredictable factors. To manage the volatility related to anticipated purchases of certain of these materials, we use futures and options with maturities generally less than one year and swap contracts with maturities up to five years. These market instruments generally are designated as cash flow hedges under SFAS 133. The effective portion of the changes in fair value for these instruments is reported in other comprehensive income and reclassified into earnings in the same financial statement line item and in the same period or periods during which the hedged transactions affect earnings. The ineffective portion is immediately recognized in earnings. The impact of the Company's commodity hedging activity was not material to our financial statements for any of the years presented.
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The Right Medicine: A Strategy for Pharmaceutical Care in Scotland was published in February 2002. A major action point was to produce guidance on joint working between NHSScotland and the pharmaceutical industry to ensure common understanding and improve patient care. The guidance aims to establish a common understanding on joint working by highlighting examples of good practice. Some of the important points to note from the guidance are: All joint working must be for the benefit of patients. All patient identification should be removed from data as per the Data Protection Act to preserve patient confidentiality. Development of protocols and or guidelines should be under the control of the NHS All joint working projects must promote and enhance equitable access to evidence-based healthcare Joint working should not undermine or conflict with the ethical requirements of any healthcare professional The interests of individual patients must be protected The joint working agreement should not be seen as an endorsement or promotion of a specific medicine or technology Reports or information about joint projects should not be used or published without the permission of all partners entering the agreement The Pharmaceutical Industry must comply with the relevant Code of Practice at all times All NHSScotland employees independent contractors involved must comply with NHS and relevant professional bodies ; codes of conduct. Clinicians requesting addition of a medicine to the Lanarkshire Joint Formulary must provide a `declaration of interest' e.g. company shares or industry research grants and ensure that decisions are based on clinical and cost-effectiveness information and atacand.
Photodynamic therapy involves applying a photosensitizing agent to each actinic keratosis, followed by exposure to light of a specific wavelength; this leads to cell death.21 Protocols for using photodynamic therapy to treat actinic keratoses vary with regard to the photosensitizing agent; amount of application; and light source, intensity, and dose. Two protocols are approved for use in the United States.22 The use of the photosensitizing agent aminolevulinic acid Levulan Kerastick ; followed by blue light exposure was approved by the U.S. Food and Drug Administration FDA ; in 1999 for the treatment of nonhyperkeratotic lesions on the face and scalp. The protocol specifies a 14- to 18-hour incubation period between application of aminolevulinic acid and light exposure; however, a subsequent study has demonstrated the effectiveness of shorter incubation periods.23 Another protocol using the photosensitizing agent methyl aminolevulinate Metvixia; not yet available in the United States ; followed by red light exposure was approved by the FDA in 2004. This protocol specifies a three-hour incubation period. Photodynamic therapy is well tolerated, has excellent cosmetic results, and has reported cure rates between 69 and 93 percent.16, 21, 24 Potential adverse effects include initial erythema; edema; a burning sensation; pain; and crusting followed by hypo- or hyperpigmentation, ulceration, or scaling.16, 21.
Rs in lakhs ; For the year ended 31st March INCOME Sales Other Income Total Income EXPENDITURE Material Cost Purchase of Goods Materials for Resale Excise Duty Staff Cost Other Expenses Preliminary Expenses Depreciation Increase ; Decrease in Stock Total Expenditure PROFIT BEFORE TAXATION Provision for Taxation Current Tax Earlier year Tax Deferred Tax Wealth Tax ADD: Excess Provision for Taxation for earlier years PROFIT AFTER TAXATION Minority Interest Net Profit Attributable to Parent Add: Surplus Brought Forward refer note 2 of sch. 20 ; Available for Appropriation APPROPRIATIONS Interim Dividend Tax on Interim Dividend Proposed Final Dividend Tax on Proposed Final Dividend Contingency Reserve General Reserve BALANCE CARRIED.
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