Six-week Study Research Articles

Annotated abstracts

Annotated abstracts

Growth Parameters and Carcass Quality of Broilers Fed a Corn-Soybean Diet Supplemented with Creatine Monohydrate

A six-week study was conducted to determine the feed efficiency and carcass quality of broilers supplemented creatine monohydrate. Day-old (unsexed) broiler chicks (n = 288) were allotted to one of three dietary treatments (12 chicks/pen, eight replications/treatment) using a completely randomized design. The control diet (diet A) contained 0% creatine throughout the entirety of the six week study. Diet B contained 0% creatine weeks 1-3 and 0.63% creatine weeks 4-6, while diet C contained 1.05% creatine weeks 1-3 and 0.63% creatine weeks 4-6. Each diet was formulated to meet or exceeded the nutrient requirements of broilers. During week four of the experiment, the feed efficiency of chicks fed diet B was superior (P < 0.05) to that of birds fed diet A. Intramuscular pH measured at 30 min postmortem was lower (P < 0.05) in the breast meat of broilers fed diet C. Moreover, the breast meat from broilers fed diets B and C was paler (higher L*-values) than that of birds fed the control diet (P < 0.05). In conclusion, the data indicate that feed efficiency was improved from weeks three to four after a creatine loading period. However, the carcasses from broilers fed creatine exhibited a paler breast meat color and a lower breast muscle pH (diet C) when compared to diet A.

Therapeutic effects of milnacipran (serotonin noradrenalin reuptake inhibitor) on depression following mild and moderate traumatic brain injury.

The present study investigated the efficacy and safety of milnacipran, a serotonin noradrenalin reuptake inhibitor (SNRI), for the treatment of depression following mild and moderate traumatic brain injury (MMTBI). While other reports have been published on the use of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and tricyclics for the treatment of depression following MMTBI, no previous study has examined the use of a SNRI for this condition. A six-week open study was conducted using 10 patients (4 males and 6 females) of ages ranging from 28 to 74 years. DSM-IV (diagnostic statistical manual of mental disorders, 4th Ed. American psychiatric association, 1994) was used to diagnose mood disorders. The severity of depression was measured with the 21-item Hamilton rating scale for depression (HAM-D). The cognitive state of the patients was assessed using the mini-mental state examination (MMSE). The maximum daily milnacipran dosage for the patients ranged from 30 to 150 mg. One patient experienced side effects, but none of the side effects were serious. On the basis of having a decrease in a final HAM-D score of more than 50%, the response rate for the nine patients was 66.7%, while in a final score of 7 or less, the remission rate for the nine patients was 44.4%. Furthermore, significantly greater improvement in cognitive function was seen in patients treated with milnacipran. The results demonstrated that milnacipran is a safe and effective drug for depression following mild and moderate TBI and could be the first choice drug for the treatment of this condition.

Ready-to-eat Cereal Used as a Meal Replacement Promotes Weight Loss in Humans

Objectives: The primary aim was to determine whether ready-to-eat cereal used as a portion-controlled, meal replacement promotes weight loss. Additional aims were to determine whether weight loss differed if the cereal was provided as a single brand or variety of brands and whether this use of ready-to-eat cereal promotes continued weight loss following transition to a high-fiber, high-volume (Volumetric) diet.Methods: Body composition was measured and diet records, appetite questionnaires and activity logs were completed during baseline and end of intervention weeks 2 and 6. Participants were assigned to one of four treatment groups. Group 1 (6 M, 22 F, mean age 43.0 ± 1.9 years, mean initial BMI 28.9 ± 0.4 kg/m2) consumed a serving of a single brand of ready-to-eat cereal with 2/3 C skim milk and a 100 Kcal portion of fruit for breakfast and as a replacement for either lunch or dinner for weeks 1 and 2. No restrictions were placed on the non-cereal meal. They then followed the Volumetric diet for weeks 3 to 6 with a target energy restriction of 500 kcal/day. Group 2 (3 M, 25 F, mean age 40.9 ± 2.3 years, mean initial BMI 29.39 ± 0.6 kg/m2) followed the same protocol, but was permitted to select from a variety of ready-to-eat cereals during weeks 1 and 2. Group 3 (7 M, 19 F, mean age 41.6 ± 2.4 years, mean initial BMI 29.3 ± 0.6 kg/m2) received no dietary instruction during the six-week study and Group 4 (9 M, 18 F, mean age 38.2 ± 2.8 years, mean initial BMI 29.3 ± 0.6 kg/m2) received no intervention prior to adoption of the Volumetric diet for weeks 3 to 6.Results: The cereal interventions resulted in 640 ± 109 and 617 ± 105 kcal/day reductions of energy intake in Groups 1 and 2, respectively, during the two-week cereal intervention. This led to comparable mean weight losses (1.91 ± 0.19 kg—Group 1, 1.37 ± 0.15 kg—Group 2) that were significantly greater than that observed in Group 3 (0.08 ± 0.15 kg). The losses were primarily of fat mass. No significant changes of total body water were observed. Weight loss continued during the Volumetric diet in Groups 1 and 2. The changes were comparable to those observed in Group 4, and all were significantly greater than that of Group 3. Self-reported hunger was slightly, but significantly higher than baseline in Groups 1 and 2 during the cereal intervention, but similar to baseline in Groups 1, 2 and 3 during the Volumetric diet. Based on predicted weight loss, compliance with the Volumetric diet was similar and limited in all three intervention groups.Conclusions: Ready-to-eat cereals may be used to promote weight loss when consumed as a portion-controlled, meal replacement. Provision of a variety of brands does not compromise efficacy. Weight losses may be maintained or increased after transition to the Volumetric diet. The later regimen effectively controls hunger and may lead to weight loss, but compliance is limited.

Duloxetine pharmacology: profile of a dual monoamine modulator.

Dysregulation within central monoaminergic systems is believed to underlie the pathology of depression. Drugs that selectively inhibit the reuptake of central monoamines have been used clinically to alleviate symptoms of depressive illnesses. Duloxetine, a novel compound currently under investigation for the treatment of depression, binds selectively with high affinity to both norepinephrine (NE) and serotonin (5-HT) transporters and lacks affinity for monoamine receptors within the central nervous system. It has been suggested that dual inhibition of monoamine reuptake processes may offer advantages over other antidepressants currently in use. In preclinical studies, duloxetine mimics many physiologic effects of antidepressants. Consistent with other antidepressants, duloxetine, by acute administration, elevates extracellular monoamine levels, while by chronic administration it does not alter basal monoamine levels. Like the selective serotonin reuptake inhibitor, fluoxetine, by microiontophoretic application, duloxetine inhibits neuronal cell firing. However, in comparison with fluoxetine, duloxetine is a more potent serotonin reuptake inhibitor. Furthermore, in behavioral experiments, duloxetine attenuates immobility in forced swim tests in animal models of depression to a greater extent than several other commonly used antidepressants. In a six-week open label uncontrolled study, duloxetine was evaluated in patients with a history of depression. Duloxetine was effective in treating depression as determined by marked reduction in Hamilton Depression Rating scores. Adverse effects reported during duloxetine treatment were minor and similar to those of other antidepressants. In an eight-week multicenter, double-blind, placebo-controlled study in patients with a major depressive disorder, duloxetine was effective as an antidepressant, particularly in patients with greater symptom severity. Only limited data are available regarding the pharmacokinetic profile of duloxetine in humans, although a half-life of 10 to 15 h has been reported. Studies conducted in healthy human subjects confirm the preclinical profile of duloxetine as an inhibitor of 5-HT and NE reuptake. Taken together, existing data suggest that duloxetine is a novel and effective antidepressant.

Reproducibility of the hemodynamic response to auditory oddball stimuli: a six-week test-retest study.

Determining the reliability and reproducibility of the hemodynamic response is important for the interpretation and understanding of the results of functional magnetic resonance imaging (fMRI) experiments. We describe a whole brain fMRI study designed to examine the reproducibility of the event-related hemodynamic response elicited by low-probability task-relevant target stimuli and low-probability task-irrelevant novel stimuli assessed 6 weeks apart. Reliable activation was observed during test and retest for processing of target stimuli in multiple frontal, temporal, parietal, cerebellar, and subcortical sites. Novel stimuli elicited reliable activation during test and retest in lateral frontal cortex, inferior parietal lobule, and lateral temporal cortex, though there was evidence of habituation at some cortical sites. The patterns of activation associated with target detection and novelty processing are consistent with the intracranial distribution of the neural sources generated during similar tasks and replicate the results of previous event-related fMRI studies. The observed pattern of results supports the hypothesis that the hemodynamic response to target and novel stimuli is highly reproducible over the 6-week test-retest period.

Activation of Complement Components and Reduced Regulator Expression in Alcohol-Induced Liver Injury in the Rat

The purpose of this study was to evaluate the possible contribution of complement-mediated inflammation to the development of alcoholic liver disease. Male Wistar rats were fed ethanol by liquid diet in a model that results in continuous ethanol intoxication and induces early signs of alcoholic liver injury. After a six-week study period liver samples were analyzed for the deposition of complement components (C1, C3, and C8) and expression of cell membrane-bound regulators (Crry and CD59). Activation of the homologous complement system in vitro was tested by treating frozen liver sections with normal rat serum (NRS). Immunohistochemical analysis showed deposits of C8 in the liver sections of ethanol-treated rats. When frozen liver sections from these rats were treated with NRS, periportal deposition of both C3 and C8, but only slight C1 deposition, was observed. Immunohistochemical and Western blot analysis both revealed a reduced expression of the complement regulators Crry and CD59. These results suggest an induction of complement-activating capacity in the liver after chronic ethanol treatment. Lack of C1 deposition in the lesions suggests that complement activation occurs primarily via the alternative pathway. The reduced expression of the critical complement regulatory proteins Crry and CD59 may sensitize the liver to complement-mediated damage.

Effects of folate, vitamin B-12 and vitamin B-6 supplementation on methionine-induced hyperhomocysteinemia in rats

An excessive intake of dietary methionine increases plasma total homocysteine (tHcy, an independent risk factor for premature cardiovascular disease) by enhancing the synthesis of homocysteine. Information on the influence of excess dietary vitamins involved in homocysteine metabolism on the methionine-induced hyperhomocysteinemia is, however, limited. Thus, a six-week study was conducted to determine the influence of excess folic acid, vitamin B-12 and vitamin B-6 on the methionine-induced hyperhomocysteinemia in rats. Supplementation of the casein control diet with 10 and 20 g/kg L-Met increased plasma tHcy to 2.0 and 8.0 times control, respectively. The hyperhomocysteinemia caused by the addition of 10 g/kg L-Met to the control diet, was completely counteracted by extra folic acid or three vitamins combined (folic acid, 2 mg/kg; vitamin B-12, 25 μg/kg; plus vitamin B-6, 6 mg/kg) but the addition of extra vitamin B-12 or vitamin B-6 alone had no effect on plasma tHcy. Similarly, extra dietary folic acid or the three vitamins combined caused substantial reduction in plasma tHcy of rats fed the control diet supplemented with 20 g/kg L-Met but addition of vitamin B-12 or vitamin B-6 alone exacerbated plasma tHcy.

Video-mediated communication in the classroom to support sick children: a case study

Video mediated communication is a valuable educational resource because it provides access to otherwise unreachable learning materials, it motivates students, and helps them improve their communication skills. Over the last four years we have developed a unique application of video mediated communication known as Wayne Gretzky's Providing Education By Bringing Learning Environments to Students (PEBBLES). This is a video-mediated communication system that has been designed to link a child in the hospital with his/her regular classroom. Analysis of video tape data from a six-week case study documenting the frequency of interactions and usage behaviors indicates that the student was able to spend most of her in-class time focussing on the academic tasks assigned to the class despite some technical difficulties and distractions in her local environment. Audio difficulties persisted throughout the study and must be improved in future design iterations of the system. Relevance to industry Successful use of videoconferencing in the classroom has not been well documented. A communication system that combines videoconferencing technologies and a physical avatar has been designed for use by sick children to attend school. An evaluation methodology and a case study presenting the results are beneficial to learning technology industries and users as well as videoconferencing industries.

Effect of Wheat Bran Fiber and Bran Particle Size on Fat and Fiber Digestibility and Gastrointestinal Tract Measurements in the Rat

ABSTRACTThe effect of wheat bran (AACC hard red) and bran particle size on fat and fiber digestibility and gastrointestinal tract measurements were investigated with diets containing 5.7–10.7% dietary fiber. Fifty‐six male weanling Sprague‐Dawley rats were randomly assigned to four diets containing 5% cellulose (C5); 10.5% cellulose (C10); 21.5% coarse (2 mm) wheat bran (CB); or 22.2% fine (0.5 mm) wheat bran (FB) in a sixweek study. Dietary fiber digestibilities were significantly different (P &lt; 0.05) among treatment diets (CB &gt; FB &gt; C5 &gt; C10) but there was no effect in fat digestibility among treatments. High‐fiber diets fed to rats resulted in significantly greater wet and dry fecal weights than low‐fiber diets. Bran diets resulted in significantly higher fecal moisture than cellulose diets. Cecum lengths increased significantly with bran diets compared with cellulose diets. The CB diet resulted in significantly higher stomach weights than with cellulose diets. Stomachs were heavier and cecal lengths were greater with bran diets than with cellulose diets; however, a high‐cellulose diet resulted in increased colon weight. Except for higher fiber digestibility of coarse bran, bran particle size had no significant effects. Healthful effects of wheat bran may be associated with gastrointestinal morphology and function. Fecal bulking and decreased intestinal transit time can prevent constipation and may dilute or reduce absorption of toxic or carcinogenic metabolites, thus improving gastrointestinal health and lowering the risk of tumor development and cancer.

A Case Study of Videoconferencing in the Classroom: A Methodology for Measuring Interactions, Behaviors and Attitudes

Videoconferencing is a valuable educational resource because it provides access to otherwise unreachable learning materials, it motivates students, and helps them improve their communication skills. Over the last four years we have developed a unique application of videoconferencing known as Wayne Gretzky's PEBBLES (Providing Education By Bringing Learning Environments to Students). This is a video-mediated communication system that has been designed to link a child in the hospital with his/her regular classroom. Analysis of video tape data from a six-week case study documenting the frequency of interactions and usage behaviors indicate that the student was able to spend most of her in-class time focussing on the academic tasks assigned to the class despite some technical difficulties and distractions in her local environments. Audio difficulties persisted throughout the study and must be improved in future design iterations of the system.

Inhaled Corticosteroids in Stable COPD Patients

To investigate possible changes in cells and molecular mediators of airway inflammation following inhaled steroid treatment of stable COPD patients. Six-week open preliminary prospective study. A university respiratory disease clinic. : Stable COPD patients with mild disease. Six-week treatment with inhaled beclomethasone (1.5 mg die). The levels of interleukin (IL)-8, myeloperoxidase, eosinophilic cationic protein and tryptase, and cell numbers in bronchial lavage specimens were determined, and the symptom score, the endoscopic bronchitis index, and functional parameters were recorded. After treatment there were significant reductions in the lavage levels of IL-8 ([mean +/- SEM] 1,603.4 +/- 331.2 vs 1,119.2 +/- 265.3 pg/mL, respectively; p = 0. 01) and myeloperoxidase (1,614.5 +/- 682.3 vs 511.2 +/- 144.2 microg/L, respectively; p = 0.05), in cell numbers (250.6 +/- 27.7 vs 186.3 +/- 11.5 cells x 10(3)/mL, respectively; p = 0.04), neutrophil proportion (59.7 +/- 14.3% vs 31.5 +/- 10.1%; p = 0.01), symptom score (4.5 +/- 0.6 vs 1.4 +/- 0.5; p = 0.01), and bronchitis index (8.5 +/- 0.8 vs 5.5 +/- 0.7; p = 0.007). In stable patients with COPD, inhaled steroid treatment may induce changes on some cellular and molecular parameters of airway inflammation.

100. Comparative efficacy of olanzapine and haloperidol for patients with treatment-resistant schizophrenia

There is relatively little information regarding the efficacy of newer atypical antipsychotic drugs for patients with schizophrenia who are treatment-resistant to neuroleptic agents. Several lines of evidence suggest that a clinical trial of olanzapine in this population is warranted. A sub-population of patients (N = 526) meeting treatment-resistant criteria selected from a large, prospective, double-blind, six-week study assessing the efficacy and safety of olanzapine and haloperidol was examined. Both last-observation-carried-forward (LOCF) and completers (observed cases) analyses were conducted. Olanzapine demonstrated significantly greater mean improvement from baseline in Positive and Negative Syndrome Scale (PANSS) negative symptoms, co-morbid depressive symptoms assessed by the Montgomery-Asberg Depression Rating Scale, akathisia as measured by Barnes Akathisia Scale and extrapyramidal symptoms as measured by Simpson-Angus Extrapyramidal Rating Scale with both LOCF and completers analyses. In addition, olanzapine was significantly superior to haloperidol for Brief Psychiatric Rating Scale (BPRS) total (p = .006), PANSS total (p = .005), and PANSS positive symptoms (p = .017) in completers of the six-week study. Significantly greater response rates were observed in olanzapine-treated (47%) than haloperidol-treated (35%) patients in the LOCF analysis (p = .008), but significance was not reached in the completers analysis (p = .093). Mean doses (±SD) of olanzapine and haloperidol were 11.1 ± 3.4 mg/day and 10.0 ± 3.6 mg/day, respectively. Olanzapine was superior to haloperidol for key symptom domains and parkinsonian adverse events. Implications of these data for the therapeutics of this severely ill subgroup are discussed.

A pilot trial assessing the efficacy of paroxetine hydrochloride (Paxil®) in controlling hot flashes in breast cancer survivors

Many breast cancer survivors suffer debilitating hot flashes. Estrogen, the drug of choice in perimenopausal women, is generally not recommenced to breast cancer survivors. Nonhormonal treatments are mostly disappointing. Anecdotal reports in our institution suggested that the selective serotonin-reuptake inhibitor, paroxetine hydrochloride, might be efficacious in alleviating hot flashes. Thirty women with prior breast cancer who were suffering at least two hot flashes a day entered a single institution pilot trial to evaluate paroxetine's efficacy in reducing the frequency and severity of hot flashes. After completing daily diaries for one week on no therapy, the women received open-label paroxetine, 10 mg daily for one week, followed by four weeks of paroxetine, 20 mg daily. The women completed hot-flash daily diaries throughout the study period, and a health-related symptom-assessment questionnaire and a quality-of-life rating scale in the first and sixth week of the study. Twenty-seven women completed the six-week study period. The mean reduction of hot flash frequency was 67% (95% confidence interval (95% CI): 56%-79%). The mean reduction in hot flash severity score was 75% (95% CI: 66%-85%). There was a statistically significant improvement in depression, sleep, anxiety, and quality of life scores. Furthermore, 25 (83%) of the study participants chose to continue paroxetine therapy at the end of study. The most common adverse effect was somnolence, resulting in drug discontinuation in two women, and dose reduction in two women. One woman discontinued drug due to anxiety. Paroxetine hydrochloride is a promising new treatment for hot flashes in breast cancer survivors, and warrants further evaluation in a double-blind randomized placebo-controlled trial.

The cost of inappropriate admissions: a study of health benefits and resource utilization in a department of internal medicine.

High rates of inappropriate hospital admissions have been found in numerous studies, suggesting that a high percentage of hospital resources are, in effect, wasted. The degree to which this is true depends on how costly inappropriate admissions are compared to other admissions. This study aimed to estimate both the percentage and cost of inappropriate admissions. Department of internal medicine at a teaching hospital. Consecutively admitted patients during a six-week study period. Assessments of inappropriateness were based on estimates of health benefit and necessary care level. These estimates were made by expert panels using a structured consensus method. Health benefit was estimated as gain in quality-adjusted life years, or degree of short-term improvement in quality of life during or shortly after the hospital stay. The direct costs to the hospital of each stay were estimated by allocating the costs of labour, 'hotel' and overhead according to length of stay and adding to this the cost of ancillary resources used by each individual patient. A total of 422 admissions were included. The 102 (24%) judged to be inappropriate had a lower mean cost (US$ 2532) than the other 320 (US$ 5800) (difference 3268; 95% confidence interval 1025-5511). The inappropriate admissions accounted for 12% of the total costs. Denying care for inappropriate admissions does not generate cost reductions of the same magnitude. Policy makers should be cautious in projecting the cost savings potential of excluding inappropriate admissions.

Economic impact of a drug information service.

A cost-avoidance model was developed to determine potential cost savings or "avoidance" that results from a drug information service (DIS) responding to drug information requests. Patient-specific questions received by the DIS were reviewed and evaluated. A panel determined whether a drug misadventure event may have occurred if the DIS had not been consulted. Potential outcomes from drug information requests were classified using a decision-tree model. A severity rating was then attached to each applicable request to predict potential cost savings of the DIS. Seventy-seven of the 570 drug information responses received in the six-week study period had assessable potential cost savings to the institution. During the study interval, potential cost savings were estimated to be $195,000. Projected to one year, potential cost savings reached $1.7 million. Of the savings noted, most were attributable to prevention of increased monitoring or additional treatment. Using a sensitivity analysis, annual potential cost savings ranged from $417,792 to $2,052,740 per year. Based on the estimated annual costs related to maintaining a DIS of $145,950, the resultant range of benefit/cost ratio is 2.9:1 to 13.2:1. This model demonstrates that the DIS at our institution provides potential cost savings. This model may be modified to evaluate potential cost savings in other areas of pharmacy practice.

Comparison of Buprenorphine and Methadone in the Treatment of Opioid Dependence

A three-centre, randomised, double-blind study was designed to compare the efficacy and safety of buprenorphine and methadone. This was the first European study to compare these agents and was based on a previous trial performed in the US. Opioid-dependent subjects were randomised to receive either sublingual buprenorphine or oral methadone daily. Both objective and subjective measures of efficacy were monitored weekly, and safety parameters were regularly monitored over the entire six-week study. Urinalysis showed that the two treatments were similar with a slight increase in opioid-negative urines noted in both groups. The retention rate in the buprenorphine group was lower than in the methadone group, although it has been suggested that the buprenorphine dose may have been too low for some patients. None of the side effects noted were considered serious and all were attributable to chronic opioid dependence. Experience of two years substitution treatment in Fribourg suggests that initial induction onto buprenorphine allows for patients to be subgrouped before being given the most appropriate maintenance agent. Further investigation is required into the different dose-related effects of buprenorphine seen in particular subsets of addicts.

Soy-Enhanced Products can Increase Protein Intake of Long-Term Care Residents

The importance of sufficient protein intake of the elderly, especially those in long-term care facilities (LTCF), is well established. Marginal protein intake has been shown to result in loss of lean muscle mass and immune function. Soy is a complete, high quality protein, which can be added to a wide variety of products to enhance the texture and nutritional quality of foods such as meats, breads, desserts, and cereals. This study was conducted with 74 residents having a mean age of 78 years in a 460 bed LTCF. The study consisted of two, three-week cycle menus where either traditional or soy-enhanced cycle menus were served. During the soy enhanced weeks, four to six items per day from the traditional menus were replaced with similar soy-enhanced products, reaching a goal of 30 grams of soy per day. To determine amounts served, five random trays were selected and individual food items were weighed for each meal. Plate waste measurements from the 9,298 trays over the six-week study provided data on differences in acceptance of the respective cycle menus. Nutritional content of foods was calculated using the NDS system developed by the University of Minnesota. Data were subjected to an analysis of covariance to test for differences between the traditional and soy-enhanced menus regarding amount eaten, energy values, and protein values in matched meals. There was no significant difference in amount of food or energy consumed between study weeks, although the soy-enhanced products were more protein dense. The amount of protein consumed increased (p≤0.01) by 19.6% per day (13.2 grams) in the soy-enhanced compared with traditional menus. In conclusion, the energy and protein content of the foods consumed during the traditional and soy-enhanced weeks was comparable to that reported in the literature for similar populations. Soy-enhanced products incorporated into traditional LTCF menus can significantly enhance the overall protein consumption by the elderly.

PIC9 The Economic Impact of A Drug Information Service

OBJECTIVE: A cost-avoidance model was developed to determine potential cost savings (PCS) of a drug information service (DIS) that results from answering a drug information request. DESIGN: Patient-specific questions received by the drug information service were reviewed and evaluated. A panel determined whether or not appropriate drug therapy would have been employed if the DIS had not been consulted. Potential outcomes of drug information requests were classified using a decision-tree model. A severity rating with potential cost avoidance was then attached to each applicable request to predict PCS of the DIS. RESULTS: Seventy-seven of the 570 drug information responses in the six-week study period had assessable PCS to the institution. During the study interval, PCS were estimated to be $196,000. Projected to one year, PCS reached $1.7 million. Of the savings noted, most were in the categories of increased monitoring and additional treatment. Annual PCS using a sensitivity analysis ranged from $423,601 to $1,922,560 per year. CONCLUSIONS: This model demonstrates that the DIS at our institution does provide substantial cost avoidance. This model may be modified to evaluate PCS in other areas of pharmacy practice.

Mitchell's Simple Physiological Relaxation and Jacobson's Progressive Relaxation Techniques: A comparison

Summary This study aimed to compare the short-term physiological effects of Mitchell's simple physiological relaxation and Jacobson's progressive relaxation. Twenty-four normotensive subjects, 14 men and ten women, participated in the six-week study. Systolic blood pressure (SBP) and diastolic blood pressure (DBP), respiratory rate (RR) and heart rate (HR) were monitored by conventional methods. Each subject underwent a baseline period to ascertain pre-study parameter values, following which subjects were randomly assigned to three groups. Each group received two 25-minute sessions of each of the relaxation techniques, and two sessions of the control condition of 25 minutes supine lying. The sequence of intervention differed among the three groups. Physiological parameter measurements were taken immediately before and after intervention. Following intervention with simple physiological relaxation, there were significant reductions in SBP and HR (both p