An evaluation of an adapted United States model of pharmaceutical care to improve psychoactive prescribing for nursing home residents in Northern Ireland (Fleetwood NI Study).

OBJECTIVES: To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI).

DESIGN: Cluster randomized controlled trial.

SETTING: Nursing homes randomized to intervention (receipt of the adapted model of care; n=11) or control (usual care continued; n=11).

PARTICIPANTS: Residents aged 65 and older who provided informed consent (N=334; 173 intervention, 161 control).

INTERVENTION: Specially trained pharmacists visited intervention homes monthly for 12 months and reviewed residents' clinical and prescribing information, applied an algorithm that guided them in assessing the appropriateness of psychoactive medication, and worked with prescribers (general practitioners) to improve the prescribing of these drugs. The control homes received usual care.

MEASUREMENTS: The primary end point was the proportion of residents prescribed one or more inappropriate psychoactive medicine according to standardized protocols; falls were evaluated using routinely collected falls data mandated by the regulatory body for nursing homes in NI.

RESULTS: The proportion of residents taking inappropriate psychoactive medications at 12 months in the intervention homes (25/128, 19.5%) was much lower than in the control homes (62/124, 50.0%) (odds ratio=0.26, 95% confidence interval=0.14–0.49) after adjustment for clustering within homes. No differences were observed at 12 months in the falls rate between the intervention and control groups.

CONCLUSION: Marked reductions in inappropriate psychoactive medication prescribing in residents resulted from pharmacist review of targeted medications, but there was no effect on falls.

Message from the President of the United States, transmitting documents relative to the commencement and progress of any acts or system of retaliation upon prisoners of war, by the Governments of Great Britain and the United States. --

13th Congress, 3d session. House. Doc. no. 13.

Message from the President of the United States, transmitting communications from the plenipotentiaries of the United States charged with negotiating peace with Great Britain : showing the conditions on which alone that government is willing to put an end to the war. --

13th Congress, 3d session. House. Doc. 6.

Message from the President of the United States, transmitting copies of the instructions given to the ministers of the United States appointed to negotiate a peace with Great Britain. --

13th Congress, 3d session. House. Doc. no. 8.

Message from the President of the United States to both Houses of Congress at the commencement of the second session of the twelfth Congress. --

November 4, 1812. Read, and ordered to be printed.

Message from the President of the United States to both Houses of Congress at the commencement of the second session of the twelfth Congress

November 4, 1812. Read, and ordered to be printed. Includes Documents accompanying the Message of the President of the United States to the two Houses of Congress, at the opening of the second session of the twelfth Congress United States. 12th Congress, 2nd session, 1812-1813. House.; United States. 12th Congress, 2nd session, 1812-1813. Senate.; United States. Congress. House.; United States. Congress. Senate. Printed by A. and C. Way

Message from the President of the United States, transmitting communications from the plenipotentiaries of the United States charged with negotiating peace with Great Britain

Full Title: Message from the President of the United States, transmitting communications from the plenipotentiaries of the United States charged with negotiating peace with Great Britain : showing the conditions on which alone that government is willing to put an end to the war 13th Congress, 3d session. House. Doc. 6. October 10, 1814. Referred to the Committee of Foreign Relations. Printed by Roger C. Weightman

Message from the President of the United States, transmitting copies of the instructions given to the ministers of the United States appointed to negotiate a peace with Great Britain

13th Congress, 3d session. House. Doc. no. 8. -------------------------------------------------------------------------------- October 14, 1814. Read and referred to the Committee of Foreign Relations. Printed by Roger C. Weightman

Message from the President of the United States, transmitting documents relative to the commencement and progress of any acts or system of retaliation upon prisoners of war, by the Governments of Great Britain and the United States

13th Congress, 3d session. House. Doc. no. 13. October 28, 1814. Read, referred to the Committee on Foreign Relations. Printed by A. and G. Way

Vignettes and self-reported work disability in the United States: Correction of report heterogeneity

Subjective measures of health tend to suffer from bias given by reporting heterogeneity. however, some methodologies are used to correct the bias in order to compare self-assessed health for respondents with different sociodemographic characteristics. One of the methods to correct this is the hierarchical ordered probit (hopit), which includes rates of vignettes -hypothetical individuals with a fixed health state- and where two assumptions have to be fulfilled, vignette equivalence and response consistency. this methodology is used for the self-reported work disability for a sample of the united states for 2011. The results show that even though sociodemographic variables influence rating scales, adjusting for this does not change their effect on work disability, which is only influenced by income. the inclusion of variables related with ethnicity or place of birth does not influence the true work disability. however, when only one of them is excluded, it becomes significant and affects the true level of work disability as well as income.

HEAD OF HOUSEHOLD STRUCTURE: ITS INFLUENCE ON THE DIETARY QUALITY OF U.S. HOUSEHOLDS, 1977-78 (UNITED STATES, NATIONWIDE FOOD CONSUMPTION SURVEY)

Using analysis of variance, household data collected in the Spring portion of the 1977-78 Nationwide Food Consumption Survey conducted by the United States Department of Agriculture were analyzed to examine the relationship between household characteristics and dietary quality of the household food supply. Results indicated that head of household structure was a statistically significant variable, with female headed households having higher dietary quality.^ Further analysis indicated that neither race, degree of urbanization, regional location, the education level of the female head, nor her employment status were significant variables in influencing dietary quality. The influence of head of household structure remained significant when these variables were controlled. However, income, household size, and family life cycle stage had statistically significant effects on dietary quality, and when individually controlled, the influence of head of household structure disappeared. ^

Distance Education and the Evolution of Online Learning in the United States

Online education is no longer a trend, rather it is mainstream. In the Fall of 2012, 69.1% of chief academic leaders indicated online learning was critical to their long-term strategy and of the 20.6 million students enrolled in higher education, 6.7 million were enrolled in an online course (Allen & Seaman, 2013; United States Department of Education, 2013). The advent of online education and its rapid growth has forced academic institutions and faculty to question the current styles and techniques for teaching and learning. As developments in educational technology continue to advance, the ways in which we deliver and receive knowledge in both the traditional and online classrooms will further evolve. It is necessary to investigate and understand the progression and advancements in educational technology and the variety of methods used to deliver knowledge to improve the quality of education we provide today and motivate, inspire, and educate the students of the 21st century. This paper explores the atioevolution of distance education beginning with correspondence and the use of parcel post, to radio, then to television, and finally to online education.

General index to the published volumes of the Diplomatic correspondence and Foreign relations of the United States. 1861-1899.

Published in accordance with the Sundry civil act of June 6, 1900.

Foreign relations of the United States, 1955-1957.

Includes bibliographical references and index.