Current opportunities in clinical research

The dissolution rates and bioavailability of norfloxacin in seven batches of norfloxacin capsules produced by five pharmaceutical factories were studied with rotating basket and UV-spectrophotometry. The results showed that the T50, Td and m of the samples had obvious differences, and the correlation between the dissolution rate and bioavailability differed very obviously. The method used is simple and convenient. So UV-spectrophotometry is one of the methods for the assay of norfloxacin preparations in vitro and in vivo.     

Health psychology specialty practice opportunities in a rural community hospital: Practicing local clinical science.

There is currently considerable interest in opportunities for collaboration between psychologists and primary care providers, particularly in rural settings. This article is an attempt to expand this discussion by focusing on opportunities for more specialized health psychology practices within tertiary care settings. Two examples are provided of collaborative projects recently implemented in a rural community hospital in southern New Hampshire—1 in the department of surgery, the other in the department of cardiac rehabilitation. The process of developing these practice opportunities is described within the context of the psychologist functioning as a local clinical scientist. The article concludes with a discussion of practical issues, including staffing and funding. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Utilizing collaborative practice to achieve quality outcomes in gentamicin administration

Nurses have become increasingly interested and involved in the area of outcomes to assure that the patient is represented as more than a composite of physiological variables. The use of outcome measures has helped nurses articulate their unique value and contribution to the well being of patients. Nevertheless, many measures presently used to evaluate an outcome do not identify or acknowledge the unique contribution of nurses. Clinical nurse specialists and other advanced practice nurses must use their "ways of knowing" to develop appropriate measures and outcomes. Through this careful inquiry, nurses will then be equipped to ask "nurse-driven" questions regarding the development of appropriate outcomes and outcome measures and to analyze the models in which care is presently delivered.     

Doctoral internship training opportunities in clinical geropsychology.

What types of internship training opportunities are there for psychology graduate students interested in working with older adults? The authors summarize characteristics of 65 doctoral psychology internships self-identified as offering training opportunities in clinical geropsychology. The internships appear to have the resources, staff, training placements, and training experiences that are at least adequate, and in most programs, much more than adequate, for generalist training in aging. Internship programs at facilities of the Department of Veterans Affairs compose a major resource in clinical geropsychology training. Practical suggestions are offered to graduate students interested in obtaining geropsychology training during internship and to internship program directors who may want to offer such training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunomodulators in clinical practice

Immunomodulators have opened new vistas in the management of the immunocompromised patient. They have been shown to enhance the efficacy of vaccines in infections, head and neck malignancy, the immunosuppressed and recently in AIDS. The mechanism of their action is discussed. They hold promise of further advances in immunotherapy.     

Triangulation in clinical practice

The aim of the article is to clarify the research term 'triangulation'. Examples are given to illustrate the use of triangulation in clinical practice. The strength of using triangulation in both the design and analysis stages are highlighted.     

Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care.

The long-standing divide between research and practice in clinical psychology has received increased attention in view of the development of evidence-based interventions and practice and public interest, oversight, and management of psychological services. The gap has been reflected in concerns from those in practice about the applicability of findings from psychotherapy research as a guide to clinical work and concerns from those in research about how clinical work is conducted. Research and practice are united in their commitment to providing the best of psychological knowledge and methods to improve the quality of patient care. This article highlights issues in the research- practice debate as a backdrop for rapprochement. Suggestions are made for changes and shifts in emphases in psychotherapy research and clinical practice. The changes are designed to ensure that both research and practice contribute to our knowledge base and provide information that can be used more readily to improve patient care and, in the process, reduce the perceived and real hiatus between research and practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adherence issues in clinical practice

The reproducibility of short tandem repeat (STR) amplification of aDNA extracts is limited by means of formation of artifacts during PCR. One of these artifacts, the so called allelic-dropout (failure of the amplification of alleles), may result in false-homozygote typing of a sample, if genotyping is based on the analysis of a single amplification product. 30 tooth- and bone samples collected from 17 individuals of three burial sites were investigated in a blind test. Using the polymerase chain reaction (PCR) the two independent segregating STR-loci HUMVWA and HUMTH01 were amplified. Corresponding to a mathematical estimation, multiple amplifications of each sample and genelocus were carried out. The results of this genotyping were compared intraindividually.     

Good clinical practice

Nine new phenylpropanoids (2-7, 10, 12, and 14) and two compounds representing novel structural classes of 7-O-8' and 7-O-8'.8-O-7' lignans (8 and 9, respectively) have been isolated from Illicium verum and their structures established by two-dimensional NMR. Most of these compounds appear to be biogenetically derived from threo-anethole glycol: relative stereochemistries for some members of this series were established by NOESY; absolute stereochemistries of others were determined by formation of Mosher esters.     

Noonan syndrome in clinical practice

The author presents the basic criteria for clinical recognition of Noonan syndrome. The hypothetical pathogenesis, differential diagnosis and risk of recurrence of this syndrome are also discussed.     

Study environment in clinical practice

Ultrasound treatment of the surface of festered wounds and application on them of specific heteroplasma were used in 46 patients for healing of festered wounds. The method provides broadening of the indication for application of primary suture on the festered wound and decrease of the duration of hospital stay of the patients 2.2 fold.     

Electroconvulsive therapy in clinical practice

Using electron-beam computed tomography (EBCT) with short exposure times of 100 or 50 ms and the capability of acquiring up to 2 x 17 images/s it is possible to study most of the important morphological and functional determinants of the heart. Various examples of studies in acute and chronic cardiac diseases are shown to demonstrate the use of EBCT to determine quantitatively left ventricular volumes (ml), myocardial mass (g), wall thickness changes over the cardiac cycle (mm/s), myocardial perfusion (ml/ 100 g/min) and the extent of coronary calcification (calcium score) and qualitatively the state of the proximal 4-6 cm of the subepicardial coronary arteries. The knowledge of these determinants seems very useful in excluding cardiac dysfunction, in the early recognition of cardiac disease and in the evaluation of the haemodynamic severity of coronary artery stenotic lesions. Further interdisciplinary studies are necessary to assess the clinical validity of these cardiac determinants, especially myocardial perfusion, using this advanced CT technology.     

Professional psychology and the gifted: Emerging practice opportunities.

Professional psychology has an opportunity to assume a leadership role in working with the gifted. The gifted have many unmet social, emotional, and psychoeducational needs and are arguably one of America's most valuable resources. The Duke University Talent Identification Program conducted a survey to better understand emerging issues in the gifted field. The survey identified a number of areas in which professional psychologists can play an active role. Three specific practice opportunities are discussed: assuming a leadership role in the identification of gifted students, serving as a consultant to promote talent development in the schools, and providing counseling services. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The clinical psypsychologist's opportunities and obligations in the community.

A discussion of the role of the clinical psychologist in working within society, in the community, to apply his abilities to the molding of social structure, for "only by going where society is can we maintain ourselves." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Obstetric ultrasonic studies in clinical practice

Routine ultrasound screening during pregnancy is being debated. The paper presents the aims of a three-step ultrasound screening during pregnancy care. These are exact dating of the pregnancy, detection and classification of multiple pregnancies and the detection of fetal malformations. In order to achieve these goals, we describe these three examinations. In the Cochrane Database, the efficiency of routine ultrasound screening during pregnancy is presented. Consequences of pregnancy care without routine ultrasound examinations are discussed.     

Unwanted drug effects in clinical practice

BACKGROUND AND OBJECTIVE: Unwanted drug reactions (UDR) in routine clinical practice remain largely unrecorded, even though such documentation can significantly contribute to quality assurance in drug therapy. This prospective study was undertaken to ascertain within a defined time period the frequency and significance of UDR in the medical wards of a general hospital (focus on gastroenterology) and find the organisational structures needed for its documentation. PATIENTS AND METHODS: All observed UDRs among a total of 4032 in-patients were recorded on a simple registration form, filled in by doctors assigned to collect the information, which was then analysed in cooperation with the Drug Commission of the German Medical Council (AKdA). RESULTS: UDRs were recorded in 315 patients (7.8%), 135 of them (43%) already present on admission. 101 patients had been admitted because of the UDR. Gastrointestinal disorders, particularly peptic ulcer, and skin rash were the most common UDRs. Individual drugs most frequently responsible were acetylsalicylic acid, cyclophosphamide and digoxin, the most common drug groups were nonsteroid analgesics, antibiotics and cytostatic drugs. The method employed proved to be practicable and cost-effective. CONCLUSIONS: A simple and cost-effective system, integrated into the daily medical routine, can heighten awareness of UDRs among doctors and thus improve drug safety in hospitals, while concomitantly providing an important feature of further medical education.     

Using lasers in clinical dental practice

Lasers are an impressive potential treatment modality for a variety of clinical conditions. This article profiles several clinical applications in dentistry.     

Evaluating critical thinking in clinical practice

Although much has been written about measurement instruments for evaluating critical thinking in nursing, this article describes clinical evaluation strategies for critical thinking. Five methods are discussed: 1) observation of students in practice; 2) questions for critical thinking, including Socratic questioning; 3) conferences; 4) problem-solving strategies; and 5) written assignments. These methods provide a means of evaluating students' critical thinking within the context of clinical practice.