A New Consultation Service for Community Pharmacies? An Investigation of Pharmacists\u27 Perspective on Implementing a Weight Management Program

Pharmacists are capable and interested in providing a targeted weight management intervention addressing the high rates, and associated risk, of obesity. A series of in-depth phone interviews with Mississippi community pharmacists were used to gain their perspective on a systematic approach for delivering a weight and obesity management service to patients. Using qualitative content analysis, three themes were identified and analyzed. These themes included: pharmacist’s perceptions of patient’s needs, program structural components, and pharmacist’s implementational needs. These findings can be used to expand the role of pharmacists, serve as a model for the development of other consultation services, improve health outcomes for patients with obesity, and save the healthcare system money. This investigation of pharmacists’ perspectives on the development of a weight management service could be used to design a program to minimize implementation barriers and become sustainable for the long term

A New Consultation Service for Community Pharmacies? An Investigation of Pharmacists' Perspective on Implementing a Weight Management Program

Pharmacists are capable and interested in providing a targeted weight management intervention addressing the high rates, and associated risk, of obesity. A series of in-depth phone interviews with Mississippi community pharmacists were used to gain their perspective on a systematic approach for delivering a weight and obesity management service to patients. Using qualitative content analysis, three themes were identified and analyzed. These themes included: pharmacist’s perceptions of patient’s needs, program structural components, and pharmacist’s implementational needs. These findings can be used to expand the role of pharmacists, serve as a model for the development of other consultation services, improve health outcomes for patients with obesity, and save the healthcare system money. This investigation of pharmacists’ perspectives on the development of a weight management service could be used to design a program to minimize implementation barriers and become sustainable for the long term

Citrulline Malate fails to improve German volume training performance in healthy young men and women

Background: Citrulline malate (CM) is purported to buffer lactic acid, enhance oxygen delivery, and attenuate muscle soreness. Anaerobic exercise trials with CM have produced conflicting results. Objective: The aim of the current investigation was to test the efficacy of CM on resistance training (RT) with the hypothesis that CM would improve performance. Design: A double-blind, counter-balanced, randomised control trial was utilised to assess the effects of CM on RT. 19 subjects (8 female) (25.7 ± 7.7 years), regularly engaged in RT consumed either 8 g of CM (1.1 : 1 ratio) or a placebo (6 g citric acid). Subjects attempted to perform a German Volume Training (GVT) protocol comprising 10 sets of 10 repetitions of barbell curls at 80 % of their one repetition maximum. Results: Repeated ANOVA suggested no effect of CM on RT performance (treatment × time × order p = 0.217). There was no difference (p = 0.320) in the total number of reps over the ten sets (CM median = 57, IQR 45 to 73; placebo median = 61, IQR 51 to 69). Blood lactate and creatine kinase did not differ between CM and placebo (p > 0.05). Finally, total muscle soreness was reduced significantly in CM compared to placebo (treatment × time × order p = 0.004). Conclusions: These results require corroboration; an ergogenic benefit is yet to be established and weight trainers should exercise caution when assessing the efficacy of CM. Future research should focus on the potential effects of loading doses of CM

Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness

BACKGROUND: There are conflicting data on the effects of antipsychotic medications on delirium in patients in the intensive care unit (ICU). METHODS: In a randomized, double-blind, placebo-controlled trial, we assigned patients with acute respiratory failure or shock and hypoactive or hyperactive delirium to receive intravenous boluses of haloperidol (maximum dose, 20 mg daily), ziprasidone (maximum dose, 40 mg daily), or placebo. The volume and dose of a trial drug or placebo was halved or doubled at 12-hour intervals on the basis of the presence or absence of delirium, as detected with the use of the Confusion Assessment Method for the ICU, and of side effects of the intervention. The primary end point was the number of days alive without delirium or coma during the 14-day intervention period. Secondary end points included 30-day and 90-day survival, time to freedom from mechanical ventilation, and time to ICU and hospital discharge. Safety end points included extrapyramidal symptoms and excessive sedation. RESULTS: Written informed consent was obtained from 1183 patients or their authorized representatives. Delirium developed in 566 patients (48%), of whom 89% had hypoactive delirium and 11% had hyperactive delirium. Of the 566 patients, 184 were randomly assigned to receive placebo, 192 to receive haloperidol, and 190 to receive ziprasidone. The median duration of exposure to a trial drug or placebo was 4 days (interquartile range, 3 to 7). The median number of days alive without delirium or coma was 8.5 (95% confidence interval [CI], 5.6 to 9.9) in the placebo group, 7.9 (95% CI, 4.4 to 9.6) in the haloperidol group, and 8.7 (95% CI, 5.9 to 10.0) in the ziprasidone group (P=0.26 for overall effect across trial groups). The use of haloperidol or ziprasidone, as compared with placebo, had no significant effect on the primary end point (odds ratios, 0.88 [95% CI, 0.64 to 1.21] and 1.04 [95% CI, 0.73 to 1.48], respectively). There were no significant between-group differences with respect to the secondary end points or the frequency of extrapyramidal symptoms. CONCLUSIONS: The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium. (Funded by the National Institutes of Health and the VA Geriatric Research Education and Clinical Center; MIND-USA ClinicalTrials.gov number, NCT01211522 .)

大久保利通の「富強化」構想

はじめに　本論　1. 米欧回覧帰国後の大久保　2. 朝鮮遣使問題と大久保　3. 「征韓論に関する意見書」　4. 「明治六年政変」後の新体制　おわりに

ストレッチング，噛みしめ，シャウトが膝伸展筋力に及ぼす影響

The purpose of this study was to obtain basic data for advancing game performance by clarifying the effects of static stretching, dynamic stretching, clenching and shouting on knee extension strength. The knee extension strength of a total of thirty eight people (thirty four healthy young men and four young women) divided into various groups were measured with a digital back strength meter. The following results were obtained:1. The knee extension strength increased significantly for the dynamic stretching plus warming up group and the shouting group;2. The knee extension strength decreased significantly for the static stretching group;3. There was no significant difference in the knee extension strength for the clenching group, however, there were significant effects depending on the individual.According to the results, in advancing game performance for athletes, it is important for them to use dynamic stretching and shouting corresponding to the situation while static stretching should be used modestly before the main game performance. Clenching can be used for advancing game performance for those who have shown effective results

大久保利通の「富強化」構想序説：米欧回覧と大久保

はじめに 本論 おわり