I happened to be blog surfing through some pharmacy blogs. I found an entry from another pharmacy student that made me smile. Although it was dated a year ago, it's always good to know that at the end of the day, there may be a couple of minutes to share your two cents on life in the NBA. Thanks Pharmacykid!
:)
NBA Arms Race
July 22, 2009 by pharmacykid
The 2009 NBA offseason has been pretty exciting. A lot of big names have changed teams. It seemed to start with one team obtaining a major player that would help them win the championship next year. Then two teams responded with moves in order to keep up. Then three other teams were forced to make trades. Now there are at least several teams that have a legit chance of winning the Larry O’Brien trophy next year. The following is who I think has the best chances of winning it all.
1. LOS ANGELES LAKERS
The Defending Champs. They lost Trevor Ariza to the Rockets but obtained Ron Artest. Basically, they traded a quick defender for a more powerful one. Artest does score more but his shooting percentage isn’t very good. He also punches people. We still don’t know whether Lamar Odom will return. If he doesn’t, it will be possible to dethrone the Lakers. If he does return, it will be near impossible. PLEASE MIAMI, LURE HIM AWAY!!!!
2. SAN ANTONIO SPURS
You know I’m bias. Spurs could have been #3 or #4 but I’m sticking em here. They obtained solid firepower with Richard Jefferson and a reliable big man in Mcdyess. Just look at this possible lineup: Parker, Ginobili, Jefferson, Duncan, Mcdyess.
3. BOSTON CELTICS
Rasheed Wallace is a versatile big, able to post up and shoot the 3. If Kevin Garnett can be healthy, they will contend with the Cavs and Magic for the top spot in the East.
4. DALLAS MAVERICKS
It was a hard decision placing the Mavs here instead of 2 or 3. Look at their potential lineup: Kidd, Terry, Howard, Marion, and Nowitzki. The new acquisition, Marion, gives them an athletic forward who can guard most people and score in transition. I think their weakness is that they don’t really have a closer. The Mavs always end up CHOKING!
5. ORLANDO MAGIC
They basically replaced Turkoglu with Vince Carter. I don’t think this hurts or helps them. They also lost two guards, Lee and Alston, which leaves them with Jameer Nelson who I think is a bit overrated.
6. CLEVELAND CAVALIERS
The Cavs obtained Shaq. I have no idea how they are going to do.
Thursday, December 30, 2010
Wednesday, December 29, 2010
Nursing student Question
So this past week, I've been working with my college chemistry/biology student to touch up her Nursing application. She is currently a pre-nursing student at a private Jesuit college in Southern California. As part of her application, the essay requires to share her position on health care and specifically whether it is a right or a privilege?
With the current health care debate and the legislative bills, these issues may be a sensitive subject and provides a worthwhile interview question.
As part of this research, I found this website: Pro and Cons
Now where do you stand? where do I stand? where do Pharmacists as a profession stand?
As pharmacists, there was no formal stance on government legislation. Instead, their united stance reflects the overall changes occurring within health care.
Accordingly, " APhA’s efforts were focused on increasing patient access to pharmacists clinical services to improve the quality of care and lower health care costs regardless of how the system was financed or how coverage was expanded. Medications are the first line of defense in fighting and preventing disease. However, improper medication use costs our nation approximately $177 billion a year. Pharmacists, when provided the opportunity to partner with patients and providers can improve medication use, resulting in improved health outcomes and reduced overall health care costs.
APhA leveraged the “lessons learned” from successful public and private sector programs and persuaded Congress to include several provisions that have the opportunity to optimize the benefits of pharmacists clinical services..."
Source Citation
With the current health care debate and the legislative bills, these issues may be a sensitive subject and provides a worthwhile interview question.
As part of this research, I found this website: Pro and Cons
Now where do you stand? where do I stand? where do Pharmacists as a profession stand?
As pharmacists, there was no formal stance on government legislation. Instead, their united stance reflects the overall changes occurring within health care.
Accordingly, " APhA’s efforts were focused on increasing patient access to pharmacists clinical services to improve the quality of care and lower health care costs regardless of how the system was financed or how coverage was expanded. Medications are the first line of defense in fighting and preventing disease. However, improper medication use costs our nation approximately $177 billion a year. Pharmacists, when provided the opportunity to partner with patients and providers can improve medication use, resulting in improved health outcomes and reduced overall health care costs.
APhA leveraged the “lessons learned” from successful public and private sector programs and persuaded Congress to include several provisions that have the opportunity to optimize the benefits of pharmacists clinical services..."
Source Citation
Monday, December 27, 2010
Tuesday, December 7, 2010
Tuesday, November 30, 2010
Potential Challenges within the Industry
Mary Andritz, dean of the Albany College of Pharmacy,
Read more: Pharmacy college dean talks about challenges facing the profession | The Business Review
Read more: Pharmacy college dean talks about challenges facing the profession | The Business Review
Monday, November 29, 2010
Thursday, November 25, 2010
Tuesday, November 23, 2010
Friday, November 19, 2010
Tuesday, October 26, 2010
Thursday, October 21, 2010
Tuesday, October 19, 2010
To be or not to be is the question
The answer of course is to be!
From another writer's blogpost:
“Be who you are, and be that well.” I love this quote by St. Francis de Sales. The past few years have been quite the adventure in what I believe is me discovering the unique gifts I have to offer the world and “becoming who I really am”.
The writer later goes on to write that a "life-transforming experience in which I came to experience the absolute wonder and joy of being alive," can give an change an individual. This process of self-actualization leaves us knowing "the profound difference our lives can make when we stand inside our commitments and deepest desires, rather than our fears."
From another writer's blogpost:
“Be who you are, and be that well.” I love this quote by St. Francis de Sales. The past few years have been quite the adventure in what I believe is me discovering the unique gifts I have to offer the world and “becoming who I really am”.
The writer later goes on to write that a "life-transforming experience in which I came to experience the absolute wonder and joy of being alive," can give an change an individual. This process of self-actualization leaves us knowing "the profound difference our lives can make when we stand inside our commitments and deepest desires, rather than our fears."
Monday, October 18, 2010
Saturday, October 16, 2010
Spirituality and Action
Spirituality and Religion may be synonymous in your vocabulary according to your understanding. However, if spirituality is one's outlook, is mutually exclusive from one's religion, what are new ways of becoming more present or involve in all that life has to offer? From early American Transcendentalism to today's personal empowerment movements, many Americans are looking for ways to "plug-in" to life by looking for outside guidance.
In one quote, "We are all inventors, each sailing out on a voyage of discovery, guided each by a private chart, of which there is no duplicate. The world is all gates, all opportunities." by Ralph Waldo Emerson, this process of plugging in follows with the spirit of inventiveness.
For those where spirituality and religion are mutually inclusive, spirituality can affect change in your daily interactions and conscious actions. In this case, where does spirituality stop and religion take over, or vice versa? In my case, my belief in Buddhism philosophy enhances my Catholic traditions.
In another blogger's A Buddhist Catholic Blog, he mentions that Dalai Lama noted once (please reference my earlier post ) that Buddhists have well defined methods to develop one’s inner life, while Christians have done well to develop the outer life of service to others.
In essence, my spiritual experience has influenced my daily life and is integrated into my personal identity.
Thursday, October 14, 2010
Mission and Culture: The Ingredients for Success
October 13, 2010 marked the grand opening of the Huntington Beach Bella Terra Whole Food's Market location. I ventured in knowing that their coffee and food selection was impeccable. After seeing the parking lot flooded with cars, I hoped that the inside of the store would not be the same scene. Instead the parking lot was only a small glimpse of what I saw inside the store. The crowds in every isle, food vendors at the each corner, new employees and regional management supervising the customers made Whole Foods Market a robust mini-city. The amount of people in a grocery store was on the brink of mob scene. From the fruits to the butcher, to the raw foods and even to the diverse array of lunch options, this vivacity is the epitome of health and wellness.
At the same time, Whole Foods Corporations mission and culture carries over to its successful store operations and popularity in a niche market. According to their website, "Achieving unity of vision about the future of our company, and building trust between Team Members is a goal of Whole Foods Market. At the same time diversity and individual differences are recognized and honored. We aim to cultivate a strong sense of community and dedication to the company."
The customers that walk through Whole Foods doors do so with reason and purpose. In seeking fresh produce and ingredients, customers have shown how their desire for the highest quality natural and organic products available. As proper nutrition is tried to overall health and longevity, there must be greater implications for new health modalities for these customers as well. In the same sense, what if these same customers have that same desire for accessing the highest quality healthcare professionals as well as for these professionals' services? Instead of organic products, what if these customers desired the highest quality medicines and resources for disease prevention?
Now in addition to their health isle with natural remedies and vitamins, what if new stores employed a staff pharmacist or included a pharmacy area to help those with health questions and concerns? In this way, pharmacists can serve to address community health concerns. These same pharmacists would be able to educate customers and potential patients on the benefits of preventative measures and daily wellness activities to achieve ultimate health.
In that sense, Whole Foods Market would still be fulfilling their essential values:
'
At the same time, Whole Foods Corporations mission and culture carries over to its successful store operations and popularity in a niche market. According to their website, "Achieving unity of vision about the future of our company, and building trust between Team Members is a goal of Whole Foods Market. At the same time diversity and individual differences are recognized and honored. We aim to cultivate a strong sense of community and dedication to the company."
The customers that walk through Whole Foods doors do so with reason and purpose. In seeking fresh produce and ingredients, customers have shown how their desire for the highest quality natural and organic products available. As proper nutrition is tried to overall health and longevity, there must be greater implications for new health modalities for these customers as well. In the same sense, what if these same customers have that same desire for accessing the highest quality healthcare professionals as well as for these professionals' services? Instead of organic products, what if these customers desired the highest quality medicines and resources for disease prevention?
Now in addition to their health isle with natural remedies and vitamins, what if new stores employed a staff pharmacist or included a pharmacy area to help those with health questions and concerns? In this way, pharmacists can serve to address community health concerns. These same pharmacists would be able to educate customers and potential patients on the benefits of preventative measures and daily wellness activities to achieve ultimate health.
In that sense, Whole Foods Market would still be fulfilling their essential values:
- Satisfying and delighting our customers
- Caring about our communities & our environment
- Creating ongoing win-win partnerships with our suppliers .
'
Saturday, October 9, 2010
Thursday, October 7, 2010
http://www.noprescriptioneeded.com/online-pharmacy-blog/
After receiving an email the other day about a Canadian pharmacy, I find this article rather interesting...How will this affect pharmacists as professionals and health care in general: from patients to pharmaceutical companies to insurance companies that cover prescription costs?
http://www.noprescriptioneeded.com/online-pharmacy-blog/
http://www.noprescriptioneeded.com/online-pharmacy-blog/
Tuesday, October 5, 2010
Sports Medicine and Pharmacy
Pharmacy is a people's profession. Your patients and clients come from all walks of life and it is the pharmacist that serves as a medium between information and informative action towards better heath and wellness.
In this podcast from The People's Pharmacy blog, the topic feature was sports medicine, which is a topic of interest to me.
Listen
- "Be the change you wish to see in the world."
Nicole
In this podcast from The People's Pharmacy blog, the topic feature was sports medicine, which is a topic of interest to me.
Listen
- "Be the change you wish to see in the world."
Nicole
Friday, October 1, 2010
Pharmacogenomic Discovery Allows for Improved Cancer Therapy
Science Daily and Pharmacology.
Read this link
Read this link
Wednesday, September 29, 2010
Students, Curiosity and Learning
You can teach a student a lesson for a day; but if you can teach him to learn by creating curiosity, he will continue the learning process as long as he lives. ~Clay P. Bedford
All students have talents, gifts, and passions that are waiting to be discovered. Each person learns and organizes information in a different manner. Learning at the higher levels is dependent on having attained prerequisite knowledge and skills at lower levels. When students are motivated and passionate about learning, they are able to succeed in any subject area. Each standard-based lesson taught in the workshops is guided by and exploration of the the following:
1. Knowledge: remembering or recalling appropriate, previously learned information to draw out factual (usually right or wrong) answers. Use words and phrases such as: how many, when, where, list, define, tell, describe, identify, etc., to draw out factual answers, testing students’ recall and recognition.
2. Comprehension: grasping or understanding the meaning of informational materials. Use words such as: describe, explain, estimate, predict, identify, differentiate, etc., to encourage students to translate, interpret, and extrapolate.
3. Application: applying previously learned information (or knowledge) to new and unfamiliar situations. Use words such as: demonstrate, apply, illustrate, show, solve, examine, classify, experiment, etc., to encourage students to apply knowledge to situations that are new and unfamiliar.
4. Analysis: breaking down information into parts, or examining (and trying to understand the organizational structure of) information. Use words and phrases such as: what are the differences, analyze, explain, compare, separate, classify, arrange, etc., to encourage students to break information down into parts.
5. Synthesis: applying prior knowledge and skills to combine elements into a pattern not clearly there before. Use words and phrases such as: combine, rearrange, substitute, create, design, invent, what if, etc., to encourage students to combine elements into a pattern that’s new.
6. Evaluation: judging or deciding according to some set of criteria, without real right or wrong answers. Use words such as: assess, decide, measure, select, explain, conclude, compare, summarize, etc., to encourage students to make judgments according to a set of criteria.
All students have talents, gifts, and passions that are waiting to be discovered. Each person learns and organizes information in a different manner. Learning at the higher levels is dependent on having attained prerequisite knowledge and skills at lower levels. When students are motivated and passionate about learning, they are able to succeed in any subject area. Each standard-based lesson taught in the workshops is guided by and exploration of the the following:
1. Knowledge: remembering or recalling appropriate, previously learned information to draw out factual (usually right or wrong) answers. Use words and phrases such as: how many, when, where, list, define, tell, describe, identify, etc., to draw out factual answers, testing students’ recall and recognition.
2. Comprehension: grasping or understanding the meaning of informational materials. Use words such as: describe, explain, estimate, predict, identify, differentiate, etc., to encourage students to translate, interpret, and extrapolate.
3. Application: applying previously learned information (or knowledge) to new and unfamiliar situations. Use words such as: demonstrate, apply, illustrate, show, solve, examine, classify, experiment, etc., to encourage students to apply knowledge to situations that are new and unfamiliar.
4. Analysis: breaking down information into parts, or examining (and trying to understand the organizational structure of) information. Use words and phrases such as: what are the differences, analyze, explain, compare, separate, classify, arrange, etc., to encourage students to break information down into parts.
5. Synthesis: applying prior knowledge and skills to combine elements into a pattern not clearly there before. Use words and phrases such as: combine, rearrange, substitute, create, design, invent, what if, etc., to encourage students to combine elements into a pattern that’s new.
6. Evaluation: judging or deciding according to some set of criteria, without real right or wrong answers. Use words such as: assess, decide, measure, select, explain, conclude, compare, summarize, etc., to encourage students to make judgments according to a set of criteria.
Thursday, September 23, 2010
Quote of the Day
Henry Ward Beecher said, “Hold yourself responsible for a higher standard than anyone expects of you. Never excuse yourself.”
I have always known I could do more than anyone else thought possible, and I have consistently proved myself to be more than they bargained for. I love a challenge, and do not let even a hint of an opportunity go unclaimed. If I want something, I go for it and give it all I have. I succeed because I aim high and work hard, and a graduate education will put me one step closer to achieving my goals.
When I think about a graduate degree and taking a break from the sights and experiences that I’ve known and explored for my gap years, I am filled not with fear, but instead, feel the need to rise to the occasion. To live day in and day out in a place filled with my peers who are all in the pursuit of different branches of academia, from new therapies to patient care, seems like a dream come true for me. The ability to choose and specialize my educational pursuits and goals gives me the daily motivation to make each action count.
One other quote states"Every time you get out of bed and start a new day you are giving yourself a new opportunity for experience and learning. Each day that you spend awake is a day unlike any other that has ever been lived or will be lived again. There is nothing which, once learned, serves no purpose; for, even if its only use is repeating it at an appropriate time, there is always the chance that you are planting a seed in someone’s mind. "
When I leave my home into my surroundings and spheres of influence, I step forward with a love of knowledge that has been sown and can now only flourish. Even in my daily experiences as a teacher and tutor, I have the ability to pass on what I have learned into the future. What will be truly exciting about my future education and career, is that I will have the opportunity to do so in a clinical and academic setting. My students and future patients provide me with the opportunity to educate others, as well as to learn from their experiences.
I have always known I could do more than anyone else thought possible, and I have consistently proved myself to be more than they bargained for. I love a challenge, and do not let even a hint of an opportunity go unclaimed. If I want something, I go for it and give it all I have. I succeed because I aim high and work hard, and a graduate education will put me one step closer to achieving my goals.
When I think about a graduate degree and taking a break from the sights and experiences that I’ve known and explored for my gap years, I am filled not with fear, but instead, feel the need to rise to the occasion. To live day in and day out in a place filled with my peers who are all in the pursuit of different branches of academia, from new therapies to patient care, seems like a dream come true for me. The ability to choose and specialize my educational pursuits and goals gives me the daily motivation to make each action count.
One other quote states"Every time you get out of bed and start a new day you are giving yourself a new opportunity for experience and learning. Each day that you spend awake is a day unlike any other that has ever been lived or will be lived again. There is nothing which, once learned, serves no purpose; for, even if its only use is repeating it at an appropriate time, there is always the chance that you are planting a seed in someone’s mind. "
When I leave my home into my surroundings and spheres of influence, I step forward with a love of knowledge that has been sown and can now only flourish. Even in my daily experiences as a teacher and tutor, I have the ability to pass on what I have learned into the future. What will be truly exciting about my future education and career, is that I will have the opportunity to do so in a clinical and academic setting. My students and future patients provide me with the opportunity to educate others, as well as to learn from their experiences.
Fluoxetine, CBT or Combination for Adolescents with MDD
Major Depressive Disorder (MDD) is a prevalent in 5% of adolescents. This mental disorder impacts adolescents’ health, with greater tendencies to engage in suicidal behavior and completed suicides. MDD also has social effects within the family’s structure and order. According to the World Health Organization, Major Depressive Disorder is the leading cause of disability in the U.S. for ages 15-44 (World Health Organization 2008). As a result, new developments in MDD treatments can benefit public health. In this research, the Treatment for Adolescents with Depression Study or TADS funded by the National Institute of Mental Health evaluated the effectiveness of different types of therapies in adolescents with major depression disorder. There were three different range of therapies used in the treatment: fluoxetine hydrochloride therapy, cognitive behavior therapy (CBT), and the combination of the two. Their initial hypothesis is that that combination therapy would show a larger, more rapid short-term treatment benefit than fluoxetine therapy or CBT. The second tail of the hypothesis’stated that the advantage for combination therapy relative to monotherapies of fluoxetine therapy or CBT would be evident across 9 treatment months. In summary, combination therapy would have a greater therapeutic outcome for short term( 0 to 12 weeks) and mid-range (2-36 weeks) time correlation. The greater advantages of combo therapy would also be visible in the long-run (36 weeks and greater).
The quantitative research was conducted over a span of 26 weeks in a randomized fashion. The participants of the randomized, controlled trial were included three hundred twenty-seven patients aged 12 to 17 years with a primary DSM-IV diagnosis of major depressive disorder. The research study was conducted in 13 academic and community sites across the United States. The administration protocol included that cognitive behavior and combination therapies were not masked, whereas administration of placebo and fluoxetine was double-blind through 12 weeks, after which treatments became open trails. Likewise, patients assigned to placebo were treated openly after week 12. The results from the placebo group are not included in the results and analyses of this research. In these three hundred twenty seven patients, blind independent evaluators measured the response in patients according to two standards: Children’s Depression Rating Scale– Revised (CDRS-R) total score and secondly, the response rate, defined as a Clinical Global Impressions–Improvement score of much or very much improved. Also, suicidal ideation and events will be observed in these participants. Ideation differs from events as ideation are thoughts and feelings and events were recorded as any bodily injuries outside of self-mutilation and.suicide attempts.
Medication protocol involved specific doses at time intervals and a limited amount of time for CBT sessions. Over the span of the 36 weeks, the patients were monitored over a period of 20 to 30 minute visits and offered encouragement about MDD pharmacotherapy effectiveness. Fluoxetine dosages began at 10mg/d and increased if necessary to 40mg/d at week 6. The maximum dosage was administered during the week 12 visit at 60 mg/day. CBT treatment was divided into three separate stages. The first required that patients had fifteen 1-hour sessions during the first 12 weeks of treatment. Patients, who only had a partial response, were then required to have 6 additional weeks of weekly CBT, while the others had biweekly CBT between Stage 2’s Week 12 through 18. Stage 3 patients were provided CBT every 6 weeks on a maintenance visit schedule. The outcomes and measurements were analyzed by an independent evaluator blind to the treatment condition at baseline levels and at weeks 6,12,18, 2, 30 and 36.
Result measurements would include statistical analyses using random coefficients regression (RR) models generalized estimating equations (GEEs) for binary outcomes were used to compare the
probability of treatment response over time in the 3 treatment arms. From the RR and GEE data, researchers were then able evaluate the magnitude of the influence of combination therapy and fluoxetine therapy relative to CBT by calculating the effect size and the number needed to treat (NNT).
The study results indicate a positive correlation with the first metric, the revised total score defined earlier and time treatment (P .001). Rates of response were 73% for combination therapy, 62% for fluoxetine therapy, and 48% for CBT at week 12. Halfway through the study, at week 18 the rates of response were 85% for combination therapy, 69% for fluoxetine therapy, and 65% for CBT. At week 36, the rate responses were 86% for combination therapy, 81% for fluoxetine therapy, and 81% for CBT. Data illustrates that suicidal ideation decreased with treatment, but less so with fluoxetine therapy than with combination therapy or CBT. For those patients receiving fluoxetine therapy, suicidal events were more common (14.7%) than for those receiving combination therapy (8.4%) or CBT (6.3%).
The sample of the TADS study is an appropriate reflection of the general population, and are useful in clinical and epidemiological evaluations. For MDD pharmacotherapy study, the mean age was 14.6 (1.5) years; 45.0% are male; 74.0% are non-Hispanic white; 11.3% are African American; and 9.8% are Hispanic. CDRS-R raw score at baseline or entry was 59.8 (10.3) which indicates moderate to moderately severe MDD, consistent with consistent with mean Clinical Global Impressions Severity Scale and Clinical Global Assessment Scale scores. Out of the 327 patients, 243 patients (74.3%) remained in the study at week 36. Of the 327 patients, 178 (54.4%) remained in the treatment
condition to which they initially had been randomized (n=68 for combination therapy, n=55 for fluoxetine therapy, and n=55 for CBT) The effect of CBT had a grater significance in combination theory than with Fluoxetine at each time interval. At week 12, .81 for Combination and .9 for Fluoxetine. At week 18, .71 for combination versus .57. The last measurement of magnitude of effect of combination therapy and fluoxetine relative to CBT was .17 to .12. Overall, the increase in the amount of treatment time decreases the magnitude of effect of Combination Therapy and Fluoxetine relative to CBT. This magnitude is correlated to the clinical significance of the treatment leg. Weeks 12 indicates a “large effect” as the data is bounded by .8 as a large effect. Week 18 indicate a “moderate effect” as .5 is the lower limit of effect size. Small effect is indicated by .2 and is above the data from Week 36. Patients with Suicidal Events were recorded in Table . During stages 1-3, those receiving Fluoxetine treatment had a greater percentage of events with 1.7 and 11.0 for the ITT population and OC population, respectively. Next, combination therapy was second with 8.% and 7.5% and finally CBT only with 6.3% and 5.%. Across the three stages and 327 patients, 32 patients were recorded with a suicidal event , with an overall percentage of 8 to 9.8% total.
The results of this review indicate that the scientific evidence base regarding the impact of treatment applications in adolescents with moderate to severe depression. The use of the three hundred twenty seven patients in the randomized,blind trial mimics the diversity within general population. Research results indicate that fluoxetine alone or in combination with CBT shows greater improvement in MDD patients relative to CBT alone. Despite that contrast between fluoxetine or combination therapy with CBT’s overall effect, CBT does provide health care providers and clinicians observable benefits. CBT addition to fluoxetine therapy minimizes persistent suicidal ideation and suicidal events.
These results implicate medication pharmacotherapy and procedures for MDD. The only way to accelerate the response in adolescent depressive patients is to include treatment with fluoxetine alone or in combination with CBT. The addition of CBT to depression treatment enhances the safety of medication. Just as researchers note, future health care decisions must anticipate the expected benefits and expected harms of alternative courses of treatment by taking into account all probabilities in each case. This social utilitarian perspective indicates that the best method for adolescent depression treatment is the combined treatment of fluoxetine and CBT, which appears superior to either monotherapy alone.
In conclusion, public health can benefit from acknowledgement and evidence-based treatment of adolescents with moderate to severe depression. Fluoxetine as an essential part of this treatment, should be encouraged and made available for use in clinical outcomes, especially in the field of psychiatry. This study has provided further literature on evidence-based treatment for adolescent MDD that MDD treatment knowledge is now within “informed consent.” As a result, comprehensive treatment that include the therapy discussed should be used with adolescents with moderate to severe depression.
This quantitative research and the theories associated with it can be used by nurses can use to enhance their nursing practice. One particular nursing implication is that there is solid establishment of the nurse-client, nurse-patient relationship. How a nurse decides to initiate this relationship and the interventions used for ongoing care vary with the presenting behavior. For MDD these presenting behaviors include a depressed mood or marked loss of interest or pleasure activities. In adolescents and children, MDD is visible as irritability instead of sadness. With all patients, especially adolescents, trust is still the primary goal. Above all interventions, the most important to remember are active listening and being fully present with the client. This nurse-patient relationship should also include education and sharing preventative measures. Providing information about hazards as well as benefits of treatment can affect change in the patient’s quality of life. An example of shared information would be the results and benefits provided by TADS recommended treatment for MDD. Finally, these nurses can use their knowledge and skills to set preventive measures in place to prevent future occurrences, in this case, suicidal ideation and suicidal events.
Just as the researches indicates MDD’s impact as family burden, nurses must also be aware of the family who deals with the client. If family members are part of the caregivers staff, they may benefit from supportive interventions to assist them in recognizing and dealing with their feelings as well. In this case, nurses can have a positive roll in providing an emotional and supportive mediator for these adolescents. These interventions are essential in assuring nurses are fulfilling their roles and duties as health care providers.
Works Cited
The TADS Team, Initials. (2007). The treatment for adolescents with depression study (tads). ARCH
GEN PSYCHIATRY, 64(10), Retrieved from 1132-+1144 doi: www.archgenpsychiatry.com
The World Health Organization. The Global Burden of Disease: 2004 update, Table A2: Burden of
disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004.
Geneva, Switzerland: WHO, 2008 < http://www.who.int/healthinfo/global_burden_disease /GBD_report_2004update_AnnexA.pdf.>
The quantitative research was conducted over a span of 26 weeks in a randomized fashion. The participants of the randomized, controlled trial were included three hundred twenty-seven patients aged 12 to 17 years with a primary DSM-IV diagnosis of major depressive disorder. The research study was conducted in 13 academic and community sites across the United States. The administration protocol included that cognitive behavior and combination therapies were not masked, whereas administration of placebo and fluoxetine was double-blind through 12 weeks, after which treatments became open trails. Likewise, patients assigned to placebo were treated openly after week 12. The results from the placebo group are not included in the results and analyses of this research. In these three hundred twenty seven patients, blind independent evaluators measured the response in patients according to two standards: Children’s Depression Rating Scale– Revised (CDRS-R) total score and secondly, the response rate, defined as a Clinical Global Impressions–Improvement score of much or very much improved. Also, suicidal ideation and events will be observed in these participants. Ideation differs from events as ideation are thoughts and feelings and events were recorded as any bodily injuries outside of self-mutilation and.suicide attempts.
Medication protocol involved specific doses at time intervals and a limited amount of time for CBT sessions. Over the span of the 36 weeks, the patients were monitored over a period of 20 to 30 minute visits and offered encouragement about MDD pharmacotherapy effectiveness. Fluoxetine dosages began at 10mg/d and increased if necessary to 40mg/d at week 6. The maximum dosage was administered during the week 12 visit at 60 mg/day. CBT treatment was divided into three separate stages. The first required that patients had fifteen 1-hour sessions during the first 12 weeks of treatment. Patients, who only had a partial response, were then required to have 6 additional weeks of weekly CBT, while the others had biweekly CBT between Stage 2’s Week 12 through 18. Stage 3 patients were provided CBT every 6 weeks on a maintenance visit schedule. The outcomes and measurements were analyzed by an independent evaluator blind to the treatment condition at baseline levels and at weeks 6,12,18, 2, 30 and 36.
Result measurements would include statistical analyses using random coefficients regression (RR) models generalized estimating equations (GEEs) for binary outcomes were used to compare the
probability of treatment response over time in the 3 treatment arms. From the RR and GEE data, researchers were then able evaluate the magnitude of the influence of combination therapy and fluoxetine therapy relative to CBT by calculating the effect size and the number needed to treat (NNT).
The study results indicate a positive correlation with the first metric, the revised total score defined earlier and time treatment (P .001). Rates of response were 73% for combination therapy, 62% for fluoxetine therapy, and 48% for CBT at week 12. Halfway through the study, at week 18 the rates of response were 85% for combination therapy, 69% for fluoxetine therapy, and 65% for CBT. At week 36, the rate responses were 86% for combination therapy, 81% for fluoxetine therapy, and 81% for CBT. Data illustrates that suicidal ideation decreased with treatment, but less so with fluoxetine therapy than with combination therapy or CBT. For those patients receiving fluoxetine therapy, suicidal events were more common (14.7%) than for those receiving combination therapy (8.4%) or CBT (6.3%).
The sample of the TADS study is an appropriate reflection of the general population, and are useful in clinical and epidemiological evaluations. For MDD pharmacotherapy study, the mean age was 14.6 (1.5) years; 45.0% are male; 74.0% are non-Hispanic white; 11.3% are African American; and 9.8% are Hispanic. CDRS-R raw score at baseline or entry was 59.8 (10.3) which indicates moderate to moderately severe MDD, consistent with consistent with mean Clinical Global Impressions Severity Scale and Clinical Global Assessment Scale scores. Out of the 327 patients, 243 patients (74.3%) remained in the study at week 36. Of the 327 patients, 178 (54.4%) remained in the treatment
condition to which they initially had been randomized (n=68 for combination therapy, n=55 for fluoxetine therapy, and n=55 for CBT) The effect of CBT had a grater significance in combination theory than with Fluoxetine at each time interval. At week 12, .81 for Combination and .9 for Fluoxetine. At week 18, .71 for combination versus .57. The last measurement of magnitude of effect of combination therapy and fluoxetine relative to CBT was .17 to .12. Overall, the increase in the amount of treatment time decreases the magnitude of effect of Combination Therapy and Fluoxetine relative to CBT. This magnitude is correlated to the clinical significance of the treatment leg. Weeks 12 indicates a “large effect” as the data is bounded by .8 as a large effect. Week 18 indicate a “moderate effect” as .5 is the lower limit of effect size. Small effect is indicated by .2 and is above the data from Week 36. Patients with Suicidal Events were recorded in Table . During stages 1-3, those receiving Fluoxetine treatment had a greater percentage of events with 1.7 and 11.0 for the ITT population and OC population, respectively. Next, combination therapy was second with 8.% and 7.5% and finally CBT only with 6.3% and 5.%. Across the three stages and 327 patients, 32 patients were recorded with a suicidal event , with an overall percentage of 8 to 9.8% total.
The results of this review indicate that the scientific evidence base regarding the impact of treatment applications in adolescents with moderate to severe depression. The use of the three hundred twenty seven patients in the randomized,blind trial mimics the diversity within general population. Research results indicate that fluoxetine alone or in combination with CBT shows greater improvement in MDD patients relative to CBT alone. Despite that contrast between fluoxetine or combination therapy with CBT’s overall effect, CBT does provide health care providers and clinicians observable benefits. CBT addition to fluoxetine therapy minimizes persistent suicidal ideation and suicidal events.
These results implicate medication pharmacotherapy and procedures for MDD. The only way to accelerate the response in adolescent depressive patients is to include treatment with fluoxetine alone or in combination with CBT. The addition of CBT to depression treatment enhances the safety of medication. Just as researchers note, future health care decisions must anticipate the expected benefits and expected harms of alternative courses of treatment by taking into account all probabilities in each case. This social utilitarian perspective indicates that the best method for adolescent depression treatment is the combined treatment of fluoxetine and CBT, which appears superior to either monotherapy alone.
In conclusion, public health can benefit from acknowledgement and evidence-based treatment of adolescents with moderate to severe depression. Fluoxetine as an essential part of this treatment, should be encouraged and made available for use in clinical outcomes, especially in the field of psychiatry. This study has provided further literature on evidence-based treatment for adolescent MDD that MDD treatment knowledge is now within “informed consent.” As a result, comprehensive treatment that include the therapy discussed should be used with adolescents with moderate to severe depression.
This quantitative research and the theories associated with it can be used by nurses can use to enhance their nursing practice. One particular nursing implication is that there is solid establishment of the nurse-client, nurse-patient relationship. How a nurse decides to initiate this relationship and the interventions used for ongoing care vary with the presenting behavior. For MDD these presenting behaviors include a depressed mood or marked loss of interest or pleasure activities. In adolescents and children, MDD is visible as irritability instead of sadness. With all patients, especially adolescents, trust is still the primary goal. Above all interventions, the most important to remember are active listening and being fully present with the client. This nurse-patient relationship should also include education and sharing preventative measures. Providing information about hazards as well as benefits of treatment can affect change in the patient’s quality of life. An example of shared information would be the results and benefits provided by TADS recommended treatment for MDD. Finally, these nurses can use their knowledge and skills to set preventive measures in place to prevent future occurrences, in this case, suicidal ideation and suicidal events.
Just as the researches indicates MDD’s impact as family burden, nurses must also be aware of the family who deals with the client. If family members are part of the caregivers staff, they may benefit from supportive interventions to assist them in recognizing and dealing with their feelings as well. In this case, nurses can have a positive roll in providing an emotional and supportive mediator for these adolescents. These interventions are essential in assuring nurses are fulfilling their roles and duties as health care providers.
Works Cited
The TADS Team, Initials. (2007). The treatment for adolescents with depression study (tads). ARCH
GEN PSYCHIATRY, 64(10), Retrieved from 1132-+1144 doi: www.archgenpsychiatry.com
The World Health Organization. The Global Burden of Disease: 2004 update, Table A2: Burden of
disease in DALYs by cause, sex and income group in WHO regions, estimates for 2004.
Geneva, Switzerland: WHO, 2008 < http://www.who.int/healthinfo/global_burden_disease /GBD_report_2004update_AnnexA.pdf.>
Self-related Evaluations of Health Dependent on Age
In Jason Schnittker's University of Pennsylvania study, researchers evaluated individuals' perspectives on health change as related to age. Although participants acknowledge the physical limitations associated with aging, this study examines self-evaluations of the participant’s emotional, mental, and social health as dependent on age. The study tested competing hypotheses using a large, nationally representative, and longitudinal data set. The conclusions indicate that after the age of 50, the relationship between functional limitations and health evaluations is no longer as strong. Schnittker's research team cites social comparison theory, where individuals look to outside images, in order to evaluate their own opinions and abilities. Even if this theory is a relevant feature of this study, social comparison may not be an exclusive factor of self-related health evaluations. Although one’s evaluation of physical limitations and chronic conditions may decline with increasing age, non-physical factors such as psychological conditions increase. More specifically, depressive symptoms as measured evaluation of self-rated health increase with age.
This study examines how individuals’ evaluations of health change with age. Prior research has shown that these self-evaluations predict mortality well, if not, better than disease-specific indicators (Ferraro and Farmer 1999). Researchers also recognize perceptions of health reflect patients’ symptoms and values and are essential their health-related quality of life reports (Cleary and Edgman-Levitan 1997). Schnittker's study allowed him to examine the various factors of self-related health. More importantly, these psychological health evaluations based on age can help healthcare professionals with issues related to clinical practice. Understanding the basis of age evaluations is the foundation to meeting future health care needs, specifically the need for the diagnosis and treatment of elderly persons suffering from depression. These evaluations reinforce the influence of peer groups or social environment influencing one’s own evaluation of health. Symptoms that were once overlooked are now taken into account, when the individual exhibits these same symptoms in the setting of a health diagnosis, and in turn, leads individuals to reinforce the idea of declining health. Specifically, the elderly may be especially apt to inflate their self-evaluations of health, since they are predispositioned to make downward comparisons among their peers, or social comparison. Research has labeled individuals as “lay epidemiologists” as they evaluate the severity of health conditions based on the normalcy of the condition within the age group (Croyle 1992). Similarly, the notion that illness increases with age may be attributed to the fact that simply the elderly are more aware of illness, and this awareness might, in turn, be sufficient to prompt perceptions of poor general health. In the case of depression, the elderly's belief that depression is an inevitable part of aging, loss, and grief may contribute to self-rated health evaluations, which the study measures.
The methodology of this psychological research implemented regression model analysis, and required a longitudinal design that allowed the researches to test age-based interpretations against equally viable cohort-based interpretations. This two-fold experimental design provides standard isolate age-factor results from outcomes dependent on health condition factors. This research utilized data obtained from Americans' Changing Lives (ACL), a nationally representative longitudinal study of adults aged 25 and older that is widely used in medical sociology and other disciplines to prevent any limitations normally associated with such a qualitative study. Respondents were identified using a four-stage sampling strategy, beginning with standard metropolitan statistical areas and counties, followed by smaller geographic areas, followed by houses, and last, a random selection of eligible respondents. The ACL followed an initial sample for three waves (1986, 1989, and 1994). 3,617 respondents were interviewed, with an overall response rate of 68 percent. For this experiment, the dependent variable is self-rated health. The question about self-rated health was "How would you rate your health at the present time? Would you say it is: 1 being excellent and 5 being poor?" The age groups were divided into one of six categories: 25 to 34, 35 to 44, 45 to 54, 55 to 64, 65 to 74, and 75 and older. The ACL questionnaire contained three types of morbidity indicators: chronic somatic limitations, functional limitations and a Center Epidemiological Studies Depression Scale (CES-D), which is a dimensional measure of depressive symptoms in the social sciences (Radloff 1977). In the CES-D the respondents were asked whether they experienced certain symptoms. The model used to analyze data will eliminate individual’s observed and unobserved unchanging characteristics association between self-rated health and more particular indicators, like education, income and occupation by using a fixed-effects coefficient.
The results are presented across six different tables. Table 1 presents the coefficients from 39 Age-Group Regressions of Self-Rated Health on Chronic Illness, each of the coefficients is statistically significant from zero at p < .05. Valuations of general health are correlated to a specific condition, such as cancer or arthritis, using coefficients show the strength of the relationship: the larger the coefficient is, the stronger the relationship. Social comparison predicts a decline in the size of these coefficients between age groups, and illness preoccupation predicts a coefficient increase, or a stronger relationship with age. The coefficients increase in size until approximately middle age (ages 45 to 54), when after the coefficients decrease steadily. For other chronic somatic conditions (e.g., stroke and hypertension), the coefficients fall more consistently. Although these patterns are visible, there is no clear support for the social comparison theory. Finally, the 75 and older age group had the smallest coefficient across the age groups, with the exception of cancer. Thus, even if illness is a preoccupation until late middle age, it is more than negated by social comparison in later life.
The functional limitations results had coefficients that are important: the coefficients for the least severe impairment were as large as or larger than the coefficients for Table’s1 chronic conditions. This suggests that individuals may judge their health more on the basis of successful role performance than on any other single factor. The regression models explored linear declines with age. Except for arthritis and stroke, all the declines were statistically significant. In marked contrast to the preceding patterns of chronic conditions and functional limitations, the CES-D results supported the association between self-rated health and depressive symptoms increase with age. Indeed, the coefficient doubled in size: for those aged 25 to 34, the coefficient for depression is .236, while for those over the age of 75, the coefficient is .472. Later, in table 4, multiultivariate sensitivity analyses are employed to correlate more than one of the morbidity factors. As expected by researchers, the interaction between age and depressive symptoms in Model 1 is positive and statistically significant. Model 2 suggests that this interaction remains significant even when controlling for functional limitations and the number of chronic conditions. Overall, this study illustrates the clear correlation among chronic conditions, functional impairments, and depressive symptoms, so that when all three factors are considered in the model, the relationship between depressive symptoms and self-rated health may be very different.
This study provides many implications for self-related health evaluations. Most importantly, these health evaluation results encourage additional emphasis on depression an aspect of health, especially for the elderly. The study as a whole encourages additional research on the subjectivity, construal, and social psychology of health. Although self-evaluations of general health overlap with clinical outcomes, the division between the two provides important clues to how different groups, in this case, age-groups evaluate health. This study’s results offer insights into the specific health care needs of different populations. These results highlight the connection between the decline of self-rated health, and both functional limitations and chronic conditions. For all seven chronic conditions and all levels of functional limitation, the association with self-rated health was weakest among those 75 and older. The second pattern indicates that the striking connection between depressive symptoms and self-rated health sharply increases with age. After the age of 74, some depressive symptoms become more strongly associated with self-rated health compared to other chronic-and generally severe-conditions. Although the first pattern’s functional limitations are associated with self-rated health as well as depressive symptoms, these limitations have a lesser correlation and impact with self-rated health. The implication to nursing is that we as nurses must be aware of depressive symptoms in the elderly, and increase our knowledge as to why the elderly population is depressed.
Though patterns and not clear support are attributed to social comparison theory, there are larger conclusions regarding psychological health and quality of life. It is true that social comparison accurately anticipates the declining significance of both chronic illness and functional limitations. More importantly, self-assessments of general health may appear more optimistic and more relevant than those based on the presence or absence of disease or limitations. The results suggest that emotions are an increasingly salient dimension of health, even almost outweighing other conventional morbidity indicators. Therefore, it is important to maintain a positive sense of health and evaluative tendencies used in social comparison. For nursing practice, the study gives us a deeper understanding of depression in the elderly. It tells us that in caring for them holistically, we must address the way they self-rate their health for better insight on how to care for their mental status.
Elderly interpretations of psychological health have larger implications for the diagnosis and treatment of this age group. Depressive symptoms may be increasingly relevant to self-evaluations of general health. Older generations may be more inclined to view depression as an important feature of health but less inclined to articulate and present their symptoms in ways that lead to treatment. Furthermore, these symptoms and psychological inclinations do not mean that the elderly are any more supportive of psychiatric treatment.
Works Cited
Cleary, PD., and S. Edgman-Levitan. 1997. Health Care Quality: Incorporating Consumer
Perspectives. Journal of the American Medical Association, 278:1608-12.
Ferraro, K.F., and M.M. Farmer. 1999. Utility of Health Data from Social Surveys: Is There a Gold
Standard for Measuring Morbidity? American Sociological Review, 64:303-15.
Hornstein, H., E. Fisch, and M. Holmes. 1968. Influence of a Model's Feelings about his
Behavior and his Relevance as a Comparison Other on Observers' Helping Behavior,
Journal of Personality and Social Psychology, 10: 220-6.
Schnittker, J. (2005). When Mental Health becomes Health: Age and the Shifting Meaning of
Self-evaluations of General Health. The Milbank Quarterly, 83(3), 397-423. JSTOR.
16 Sept 2010
This study examines how individuals’ evaluations of health change with age. Prior research has shown that these self-evaluations predict mortality well, if not, better than disease-specific indicators (Ferraro and Farmer 1999). Researchers also recognize perceptions of health reflect patients’ symptoms and values and are essential their health-related quality of life reports (Cleary and Edgman-Levitan 1997). Schnittker's study allowed him to examine the various factors of self-related health. More importantly, these psychological health evaluations based on age can help healthcare professionals with issues related to clinical practice. Understanding the basis of age evaluations is the foundation to meeting future health care needs, specifically the need for the diagnosis and treatment of elderly persons suffering from depression. These evaluations reinforce the influence of peer groups or social environment influencing one’s own evaluation of health. Symptoms that were once overlooked are now taken into account, when the individual exhibits these same symptoms in the setting of a health diagnosis, and in turn, leads individuals to reinforce the idea of declining health. Specifically, the elderly may be especially apt to inflate their self-evaluations of health, since they are predispositioned to make downward comparisons among their peers, or social comparison. Research has labeled individuals as “lay epidemiologists” as they evaluate the severity of health conditions based on the normalcy of the condition within the age group (Croyle 1992). Similarly, the notion that illness increases with age may be attributed to the fact that simply the elderly are more aware of illness, and this awareness might, in turn, be sufficient to prompt perceptions of poor general health. In the case of depression, the elderly's belief that depression is an inevitable part of aging, loss, and grief may contribute to self-rated health evaluations, which the study measures.
The methodology of this psychological research implemented regression model analysis, and required a longitudinal design that allowed the researches to test age-based interpretations against equally viable cohort-based interpretations. This two-fold experimental design provides standard isolate age-factor results from outcomes dependent on health condition factors. This research utilized data obtained from Americans' Changing Lives (ACL), a nationally representative longitudinal study of adults aged 25 and older that is widely used in medical sociology and other disciplines to prevent any limitations normally associated with such a qualitative study. Respondents were identified using a four-stage sampling strategy, beginning with standard metropolitan statistical areas and counties, followed by smaller geographic areas, followed by houses, and last, a random selection of eligible respondents. The ACL followed an initial sample for three waves (1986, 1989, and 1994). 3,617 respondents were interviewed, with an overall response rate of 68 percent. For this experiment, the dependent variable is self-rated health. The question about self-rated health was "How would you rate your health at the present time? Would you say it is: 1 being excellent and 5 being poor?" The age groups were divided into one of six categories: 25 to 34, 35 to 44, 45 to 54, 55 to 64, 65 to 74, and 75 and older. The ACL questionnaire contained three types of morbidity indicators: chronic somatic limitations, functional limitations and a Center Epidemiological Studies Depression Scale (CES-D), which is a dimensional measure of depressive symptoms in the social sciences (Radloff 1977). In the CES-D the respondents were asked whether they experienced certain symptoms. The model used to analyze data will eliminate individual’s observed and unobserved unchanging characteristics association between self-rated health and more particular indicators, like education, income and occupation by using a fixed-effects coefficient.
The results are presented across six different tables. Table 1 presents the coefficients from 39 Age-Group Regressions of Self-Rated Health on Chronic Illness, each of the coefficients is statistically significant from zero at p < .05. Valuations of general health are correlated to a specific condition, such as cancer or arthritis, using coefficients show the strength of the relationship: the larger the coefficient is, the stronger the relationship. Social comparison predicts a decline in the size of these coefficients between age groups, and illness preoccupation predicts a coefficient increase, or a stronger relationship with age. The coefficients increase in size until approximately middle age (ages 45 to 54), when after the coefficients decrease steadily. For other chronic somatic conditions (e.g., stroke and hypertension), the coefficients fall more consistently. Although these patterns are visible, there is no clear support for the social comparison theory. Finally, the 75 and older age group had the smallest coefficient across the age groups, with the exception of cancer. Thus, even if illness is a preoccupation until late middle age, it is more than negated by social comparison in later life.
The functional limitations results had coefficients that are important: the coefficients for the least severe impairment were as large as or larger than the coefficients for Table’s1 chronic conditions. This suggests that individuals may judge their health more on the basis of successful role performance than on any other single factor. The regression models explored linear declines with age. Except for arthritis and stroke, all the declines were statistically significant. In marked contrast to the preceding patterns of chronic conditions and functional limitations, the CES-D results supported the association between self-rated health and depressive symptoms increase with age. Indeed, the coefficient doubled in size: for those aged 25 to 34, the coefficient for depression is .236, while for those over the age of 75, the coefficient is .472. Later, in table 4, multiultivariate sensitivity analyses are employed to correlate more than one of the morbidity factors. As expected by researchers, the interaction between age and depressive symptoms in Model 1 is positive and statistically significant. Model 2 suggests that this interaction remains significant even when controlling for functional limitations and the number of chronic conditions. Overall, this study illustrates the clear correlation among chronic conditions, functional impairments, and depressive symptoms, so that when all three factors are considered in the model, the relationship between depressive symptoms and self-rated health may be very different.
This study provides many implications for self-related health evaluations. Most importantly, these health evaluation results encourage additional emphasis on depression an aspect of health, especially for the elderly. The study as a whole encourages additional research on the subjectivity, construal, and social psychology of health. Although self-evaluations of general health overlap with clinical outcomes, the division between the two provides important clues to how different groups, in this case, age-groups evaluate health. This study’s results offer insights into the specific health care needs of different populations. These results highlight the connection between the decline of self-rated health, and both functional limitations and chronic conditions. For all seven chronic conditions and all levels of functional limitation, the association with self-rated health was weakest among those 75 and older. The second pattern indicates that the striking connection between depressive symptoms and self-rated health sharply increases with age. After the age of 74, some depressive symptoms become more strongly associated with self-rated health compared to other chronic-and generally severe-conditions. Although the first pattern’s functional limitations are associated with self-rated health as well as depressive symptoms, these limitations have a lesser correlation and impact with self-rated health. The implication to nursing is that we as nurses must be aware of depressive symptoms in the elderly, and increase our knowledge as to why the elderly population is depressed.
Though patterns and not clear support are attributed to social comparison theory, there are larger conclusions regarding psychological health and quality of life. It is true that social comparison accurately anticipates the declining significance of both chronic illness and functional limitations. More importantly, self-assessments of general health may appear more optimistic and more relevant than those based on the presence or absence of disease or limitations. The results suggest that emotions are an increasingly salient dimension of health, even almost outweighing other conventional morbidity indicators. Therefore, it is important to maintain a positive sense of health and evaluative tendencies used in social comparison. For nursing practice, the study gives us a deeper understanding of depression in the elderly. It tells us that in caring for them holistically, we must address the way they self-rate their health for better insight on how to care for their mental status.
Elderly interpretations of psychological health have larger implications for the diagnosis and treatment of this age group. Depressive symptoms may be increasingly relevant to self-evaluations of general health. Older generations may be more inclined to view depression as an important feature of health but less inclined to articulate and present their symptoms in ways that lead to treatment. Furthermore, these symptoms and psychological inclinations do not mean that the elderly are any more supportive of psychiatric treatment.
Works Cited
Cleary, PD., and S. Edgman-Levitan. 1997. Health Care Quality: Incorporating Consumer
Perspectives. Journal of the American Medical Association, 278:1608-12.
Ferraro, K.F., and M.M. Farmer. 1999. Utility of Health Data from Social Surveys: Is There a Gold
Standard for Measuring Morbidity? American Sociological Review, 64:303-15.
Hornstein, H., E. Fisch, and M. Holmes. 1968. Influence of a Model's Feelings about his
Behavior and his Relevance as a Comparison Other on Observers' Helping Behavior,
Journal of Personality and Social Psychology, 10: 220-6.
Schnittker, J. (2005). When Mental Health becomes Health: Age and the Shifting Meaning of
Self-evaluations of General Health. The Milbank Quarterly, 83(3), 397-423. JSTOR.
16 Sept 2010
Friday, September 17, 2010
A Fellow Blogger
How important is it to ask the right question. For this blogger, we have posts that relate to this specific phrase, from journals to equivalencies take a moment to read this insightful blog, a bit of Covey's right-sided thinking I must say.
The dominant hemisphere
The dominant hemisphere
Monday, September 13, 2010
Passion
"Is the process of drug discovery planned, serendipity, or a combination of both? As a student, my learning institution should encourages me to unleash their curiosity, doodle, experiment, speculate, immerse themselves in the mystery, the intrigue, the puzzle. Continually modifying active ingredients and trying again and again could result in a compound, a patent, a pharmaceutical that benefits thousands.
"No branch of pharmacy will stand on its own without a good basic science foundation,"
My Role in Protocol
Addi and Cassi Hempel BioSampling Protocol
"Never doubt that a small dedicated group of people can change the world; indeed it is the only thing that ever has."
—Margaret Mead
CollabRx
"Never doubt that a small dedicated group of people can change the world; indeed it is the only thing that ever has."
—Margaret Mead
CollabRx
Cyclodextrin on ExtraTV
This sugar compound, which extracts extra cholesterol from cells, is used in cutting-edge research for two young girls named Addi and Cassi Hempel.
I've also discovered a website dedicated to informing the genera public about their disease and the current FDA approval process
Other Story Features Here
Renegade Doctors (Extra) Story about Addi & Cassi Hempel's Infusions of Cyclodextrin from Addi & Cassi Hempel on Vimeo.
I've also discovered a website dedicated to informing the genera public about their disease and the current FDA approval process
Other Story Features Here
Monday, September 6, 2010
Supplemental Personal Statement September 3, 2010
If I were to talk about a group of athletes; who worked together at least sixteen hours a week over a twelve week season and spent their free time running routes, weightlifting and running bleachers, the last thing that may come to mind is a team of women aged 18-62. As a member of the Southern California Breakers, a team of the Independent Women’s Football League, my teammates and I have worked to change the status quo and empower ourselves and other women to change the perception of acceptable roles for women in our society. The experience has taught me dedication, trust, communication and teamwork.
Through the sport I have learned and grown so much as an individual. As a rookie player, I learned to become a disciple. I observed and learned from veteran players about the rules of the field and what to do in game-situations. I learned to be task-oriented and how to fill specific roles on both the offense and defense. Developing a student-mentality was a process of evolution: team communication, application, and skills mastery. Each team member has a unique role, and even my role on the field required a specific strategy for the right situation, even when the pressure is overwhelming. Patience combined with an open-mind are essential skills if we were to fulfill our team goal of making the playoffs. Similarly, my open-mind accepted coaches’ criticism to improve and reach my full potential. “Explode through!” my coach, Jeter would sternly yell across the field repeatedly during games. Every down was an opportunity to mark my target and explode through the offensive line to sack my own worst enemy: the opposing team’s quarterback.
Each group huddle became a chance to listen and learn firsthand what could be done to stop our competitor's advancing drive. The game help me develop skills off the field as well. I learned to accept comments and criticism about how our team’s actions were too risque. With confidence and without attitude, I learned to share answers to strangers' range of questions: what sport I played, how can a semi-professional league exist... Strangers questioned what field we actually play on (I mean, what football field isn't 100 yards, the same fields as any other football game?) Or what was the team's chemistry on and off the field. If spectators only realized how much sacrifice is needed on and off the field.
The SoCal Breakers rookie experience exposed me to a diverse group of women from a variety of backgrounds: from housewives to engineers, to college-students to former Navy officers, together, we shared a remarkable experience on the field/ and within the community. I realize that this experience is beyond me as an individual.
Together, my teammates and I, as female-athletes, represent a positive and healthy approach to both the game of football and the game of life.
Through the sport I have learned and grown so much as an individual. As a rookie player, I learned to become a disciple. I observed and learned from veteran players about the rules of the field and what to do in game-situations. I learned to be task-oriented and how to fill specific roles on both the offense and defense. Developing a student-mentality was a process of evolution: team communication, application, and skills mastery. Each team member has a unique role, and even my role on the field required a specific strategy for the right situation, even when the pressure is overwhelming. Patience combined with an open-mind are essential skills if we were to fulfill our team goal of making the playoffs. Similarly, my open-mind accepted coaches’ criticism to improve and reach my full potential. “Explode through!” my coach, Jeter would sternly yell across the field repeatedly during games. Every down was an opportunity to mark my target and explode through the offensive line to sack my own worst enemy: the opposing team’s quarterback.
Each group huddle became a chance to listen and learn firsthand what could be done to stop our competitor's advancing drive. The game help me develop skills off the field as well. I learned to accept comments and criticism about how our team’s actions were too risque. With confidence and without attitude, I learned to share answers to strangers' range of questions: what sport I played, how can a semi-professional league exist... Strangers questioned what field we actually play on (I mean, what football field isn't 100 yards, the same fields as any other football game?) Or what was the team's chemistry on and off the field. If spectators only realized how much sacrifice is needed on and off the field.
The SoCal Breakers rookie experience exposed me to a diverse group of women from a variety of backgrounds: from housewives to engineers, to college-students to former Navy officers, together, we shared a remarkable experience on the field/ and within the community. I realize that this experience is beyond me as an individual.
Together, my teammates and I, as female-athletes, represent a positive and healthy approach to both the game of football and the game of life.
September 3, 2010
Health care gives golden opportunity to explore and unfold the art and craft of human biology. This fabulous and fascinating profession attracted me in the childhood, itself. The reason I chose biological sciences as my major is because of my love for science, and the love I have for learning about the human body, nature and the universe. The background knowledge about the evolution of organisms, survival instincts, immunology, drug information has interested and inspired me to become a pharmacist. I am astounded with the intricacy and meticulous procedures in this field, the need for precision when working in small spaces, the technicalities, the challenges, and the need for patience. An extraordinary caring, yet adventurous attitude to help people excited me and from that time, the drug industry became my role model.
The Business of Science course gave me new insight into the Pharmaceutical industry as a science and as a business. This had aided me in developing my approach towards looking at drug industry and health care as a whole. Dr. Treasurywala’s teachings were focused on interdisciplinary nature of strategic planning, organized thinking and drug therapy. Strategically developed drug company’s merging policies, evaluation, benchmarking of drugs, portfolio of products, pipleline of drugs, value chain are all critical factors in pharmaceutical industry. Each step in the drug development process, from preclinical phases to Phase 4, is very important. After the successful completion of clinical trials and the FDA nod, the company has to critically plan and spend money on massive marketing campaign for the launching of its developed product aimed both at doctors and directly at patients. Guest lecturers from Allergan executives had fueled my learning passion for innovation. The synergistic learning of scientific structure-function model and management principles of time, cost, or logistics was a great experience. Venture capitalist’s talk on startup companies and valuation gave me new orientation. These blends have given me a broader perspective to and a better understanding of life and a goal to aim for.
The training of pharmacology, pharmacokinetics and pharmacotherapy has helped to further the analogical therapeutic process. The challenges of researching and analyzing unknown subjects are what I find most enjoyable of academic life. This has developed my experimental skills along with the related theory. It is a rewarding feeling to be a part of an evolving class setting—Team-Based Learning. It is a fun and enjoyable experience to learn much needed skills like observation, communication, judgment, and professional behavior. The alertness, efficiency and other qualities which are needed I would love to inculcate and nurture. The application of these learnt skills for the drug development, treatment, evaluation, monitoring and management of patients would certainly derive immense satisfaction.
Furthermore, I would like to work to bridge the gap between quality healthcare delivery and access. My exposure to this practice provided me with a sense of fulfillment, a motivation to gain more knowledge in pharmacy, and most significantly determination what I want to do for rest of my life in the public health
My aspiration at this moment is to acquire double graduation in PharmD/MBA or MS in Research and Policy. A graduate education can offer me a great deal of intellectual and personal satisfaction as well as constructive challenges. I look for graduate study in order to refine my knowledge and skills in my areas of interest such as organizing clinical trials and imparting this knowledge to related pharmaceutical divisions, improving policy decisions.
The cohesive efforts and collaborative knowledge gained during MBA studies would also empower me to think laterally with acceptance of ideas with an open mind. Your esteemed university has the size and diversity of the highly qualified faculty as well as the availability of varied courses in which I seek. Your institution will give me opportunity to experience in truly State- of art Infrastructure and the chance to interact with distinguished and learned professionals.
I believe when knowledge and skills are shared, opportunities of success are numerous. I believe a real-world education will serve to give direction to my goal of a career in pharmacy. The training of pharmacology, pharmacokinetics and pharmacotherapy has helped to further the analogical therapeutic process. The challenges of researching and analyzing unknown subjects are what I find most enjoyable of academic life. This has developed my experimental skills along with the related theory. It is a rewarding feeling to be a part of an evolving class setting—Team-Based Learning. It is a fun and enjoyable experience to learn much needed skills like observation, communication, judgment, and professional behavior. The alertness, efficiency and other qualities which are needed I would love to inculcate and nurture. The application of these learnt skills for the drug development, treatment, evaluation, monitoring and management of patients would certainly derive immense satisfaction.
Furthermore, I would like to work to bridge the gap between quality healthcare delivery and access. My exposure to this practice provided me with a sense of fulfillment, a motivation to gain more knowledge in pharmacy, and most significantly determination what I want to do for rest of my life in the public health
The Business of Science course gave me new insight into the Pharmaceutical industry as a science and as a business. This had aided me in developing my approach towards looking at drug industry and health care as a whole. Dr. Treasurywala’s teachings were focused on interdisciplinary nature of strategic planning, organized thinking and drug therapy. Strategically developed drug company’s merging policies, evaluation, benchmarking of drugs, portfolio of products, pipleline of drugs, value chain are all critical factors in pharmaceutical industry. Each step in the drug development process, from preclinical phases to Phase 4, is very important. After the successful completion of clinical trials and the FDA nod, the company has to critically plan and spend money on massive marketing campaign for the launching of its developed product aimed both at doctors and directly at patients. Guest lecturers from Allergan executives had fueled my learning passion for innovation. The synergistic learning of scientific structure-function model and management principles of time, cost, or logistics was a great experience. Venture capitalist’s talk on startup companies and valuation gave me new orientation. These blends have given me a broader perspective to and a better understanding of life and a goal to aim for.
The training of pharmacology, pharmacokinetics and pharmacotherapy has helped to further the analogical therapeutic process. The challenges of researching and analyzing unknown subjects are what I find most enjoyable of academic life. This has developed my experimental skills along with the related theory. It is a rewarding feeling to be a part of an evolving class setting—Team-Based Learning. It is a fun and enjoyable experience to learn much needed skills like observation, communication, judgment, and professional behavior. The alertness, efficiency and other qualities which are needed I would love to inculcate and nurture. The application of these learnt skills for the drug development, treatment, evaluation, monitoring and management of patients would certainly derive immense satisfaction.
Furthermore, I would like to work to bridge the gap between quality healthcare delivery and access. My exposure to this practice provided me with a sense of fulfillment, a motivation to gain more knowledge in pharmacy, and most significantly determination what I want to do for rest of my life in the public health
My aspiration at this moment is to acquire double graduation in PharmD/MBA or MS in Research and Policy. A graduate education can offer me a great deal of intellectual and personal satisfaction as well as constructive challenges. I look for graduate study in order to refine my knowledge and skills in my areas of interest such as organizing clinical trials and imparting this knowledge to related pharmaceutical divisions, improving policy decisions.
The cohesive efforts and collaborative knowledge gained during MBA studies would also empower me to think laterally with acceptance of ideas with an open mind. Your esteemed university has the size and diversity of the highly qualified faculty as well as the availability of varied courses in which I seek. Your institution will give me opportunity to experience in truly State- of art Infrastructure and the chance to interact with distinguished and learned professionals.
I believe when knowledge and skills are shared, opportunities of success are numerous. I believe a real-world education will serve to give direction to my goal of a career in pharmacy. The training of pharmacology, pharmacokinetics and pharmacotherapy has helped to further the analogical therapeutic process. The challenges of researching and analyzing unknown subjects are what I find most enjoyable of academic life. This has developed my experimental skills along with the related theory. It is a rewarding feeling to be a part of an evolving class setting—Team-Based Learning. It is a fun and enjoyable experience to learn much needed skills like observation, communication, judgment, and professional behavior. The alertness, efficiency and other qualities which are needed I would love to inculcate and nurture. The application of these learnt skills for the drug development, treatment, evaluation, monitoring and management of patients would certainly derive immense satisfaction.
Furthermore, I would like to work to bridge the gap between quality healthcare delivery and access. My exposure to this practice provided me with a sense of fulfillment, a motivation to gain more knowledge in pharmacy, and most significantly determination what I want to do for rest of my life in the public health
Sunday, April 4, 2010
Blogger
While working on a letter to Senator Diane Feinstein, I was researching her Health Insurance Rate Authority Amendment proposed with the recent Health Insurance Rate Authority Amendment.
Jon Walker
Jon Walker
Saturday, April 3, 2010
Friday, March 19, 2010
Monday, February 22, 2010
Drugs on Shutter Island
Wow, just saw the newly released "Shutter Island" theater. To be honest, I was scared to see it since I can't sit through horror movies. Turns out, the violence and suspense was all in good measure. Anyhow, beyond the twisted scenes and endless rats on the secluded island, there may have been some real-world themes? One being, who knows what they were putting in those pills? the cafeteria food? the coffee? the cigarettes from the orderlies? I shaked my head and whispered into Jhonny's ear "So true!" Was it Scorsese's possible reference to placebo effect or even Troudeau's Natural Cures?
Most memorable quote: "Is it better to live as a monster or die a good man?" Hmm, makes you wonder right? How can a suspense-filled thriller allude to questions of medicine, pharmacology, and ultimately legality and morality?
Anyhow, I'm including an webpost from Viraj's Weblog as another movie synopsis.
My take: you can make a choice to kill the monsters inside you and live as a good man. Choice, choice, choice... With choices, come responsibility, responsibility with ownership, and ownership with ultimate reality and Truth. As they say, "the Truth shall set you free."
Most memorable quote: "Is it better to live as a monster or die a good man?" Hmm, makes you wonder right? How can a suspense-filled thriller allude to questions of medicine, pharmacology, and ultimately legality and morality?
Anyhow, I'm including an webpost from Viraj's Weblog as another movie synopsis.
My take: you can make a choice to kill the monsters inside you and live as a good man. Choice, choice, choice... With choices, come responsibility, responsibility with ownership, and ownership with ultimate reality and Truth. As they say, "the Truth shall set you free."
Subscribe to:
Posts (Atom)