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Medium 9781780644479

12: Polymers as Biodegradable Matrices in Transdermal Drug Delivery Systems

Kharkwal, H. CABI PDF


Polymers as Biodegradable Matrices in Transdermal Drug Delivery Systems

Bhanu Malhotra1, Harsha Kharkwal2,* and Anuradha Srivastava3

Amity Institute of Biotechnology and Amity Center for Carbohydrate Research,

Amity University, Noida, India; 2Amity Center for Carbohydrate Research and Amity

Institute of Phytomedicine and Phytochemistry, Amity University Uttar Pradesh,

Noida, India; 3Biological Sciences and Geology, Queensborough Community

College, Bayside, New York, USA



The conventional forms of oral dosage have significant disadvantages including poor bioavailability in hepatic metabolism and drug degradation in the gastrointestinal (GI) tract due to enzymes and different pH ranges in these tracts. One effective route for drug absorption into the body and then into the systematic circulation to circumvent such issues is the skin. Transdermal drug delivery systems (TDDS) have emerged, combining high therapeutic efficacy with safety, reducing the number and size of dose administration significantly. TDDS are being pioneered in medical practices as alternatives to hypodermic injections and oral drug delivery systems. The therapeutic agents are introduced through the skin into the systemic circulation through the use of transdermal patches. This chapter presents an overview of TDDS practices, and the use of various biopolymers for drug delivery, and discusses the potential advantages and issues related to them.

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Medium 9781937554637

7 Managing Data and Research Records

R. Jennifer Cavalieri Sigma Theta Tau International ePub

Managing study data and documentation may seem daunting and tedious. This chapter demonstrates ways that research personnel can effectively manage their study information by providing ideas for creative tools and templates and identifying professional habits to cultivate. The goal is to collect sound study data and transfer this raw data into a useable system. New and experienced research personnel may benefit from ideas on how to do this efficiently.

The investigator is responsible for the integrity of the research data and the physical and electronic security of the research records. Research coordinators, assistants, and regulatory specialists, working under the direction of the investigator, perform the day-to-day regulatory support, data collection, and documentation of clinical trial data.

A study sponsor, the source of funding, develops the protocol and arranges for research sites to generate the data needed to answer the research question. The sponsor has overall responsibility for the trial and should employ qualified personnel to handle and validate the data, perform the analysis, and write and submit the trial reports.

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Medium 9781780644394

22 Principles of Switching from Intravenous to Oral Administration

LaPlante. K. CABI PDF


Principles of Switching from

Intravenous to Oral Administration

Jamie L. Wagner1 and Susan L. Davis2*


University of Mississippi, Jackson, Mississippi, US; 2Wayne State University and Henry Ford Hospital, Detroit, Michigan, US


Antimicrobials are the most widely used group of drugs in the hospital setting, with almost 33% of patients at any given time receiving this type of drug

(Fraser et al., 1997; McLaughlin et al., 2005).

Almost half of these patients are receiving antimicrobials that are incorrectly prescribed or inappropriately used (Dellit et al., 2007). The overprescribing of antimicrobials has been shown to lead to increased microbial resistance, increased hospital length of stay, increased morbidity and mortality, and increased use of hospital resources. One common antimicrobial stewardship intervention for reducing unnecessary antimicrobial use and the associated cost is the implementation of an intravenous (IV) to oral (PO) conversion program or policy.

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Medium 9781780644394

32 Role of Antimicrobial Stewardship in Pediatrics

LaPlante. K. CABI PDF


Role of Antimicrobial Stewardship in Pediatrics

Jennifer L. Goldman1* and Jason G. Newland2


University of Missouri-Kansas City and Children's Mercy Hospital,

Missouri, Kansas City, US; 2Washington University School of Medicine in

St. Louis and St. Louis Children’s Hospital, Missouri, US


Antimicrobial stewardship has been an effective strategy to improve antibiotic prescribing in pediatrics. A significant reduction in antibiotic use has been observed in freestanding children’s hospitals with active antimicrobial stewardship programs (ASPs) and in outpatient settings where stewardship principles have been implemented (Andrews et al., 2012;

Gerber et al., 2013a; Hersh et al., 2015). This chapter will describe current knowledge regarding antimicrobial use in children, the negative consequences of excess antimicrobial prescribing, the factors unique to pediatric antimicrobial stewardship, and the successful stewardship strategies implemented in the inpatient and outpatient settings.

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Medium 9781786394583

Observing the Results of Reducing the Stress of Dogs During Training by the Help of Dog-appeasing Pheromone on Learning and Problem-solving Behaviours

Denenberg, S. CABI PDF

Observing the Results of Reducing the Stress of

Dogs During Training by the Help of Dog-appeasing

Pheromone on Learning and

Problem-solving Behaviours

Etkin Safak* and Nesrin Sulu

Department of Physiology, Faculty of Veterinary Medicine, Ankara University,

Ankara, Turkey

Funding: Ankara University Scientific Research Projects Coordination Unit have supported this research. Project Number: 15L0239002, 2015. This research was confirmed with ethical approval (Protocol No: 2014-16-96) by Ethical Committee of Ankara


Conflict of interest: The authors declare no conflict of interest.

Keywords: dog training, Dog Appeasing Pheromone, problem solving, working dogs, stress


Working dogs are subjected to a strict training in order to be able to fulfil their future duties in real life. This study aims to investigate the effects of the Dog

Appeasing Pheromone (DAP; Adaptil®) on reducing stress during training as well as on learning and problem-solving abilities of dogs.

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Medium 9781855754324

Antisocial Tendency

Jan Abram Karnac Books ePub

1   The evacuation experience

2   Delinquency and normal antisocial behaviour

3   The need to steal

4   Two trends: destructive and object seeking

5   The hopeful moment

6   The antisocial tendency and psychoanalysis

A ntisocial tendency is a term inextricably linked with deprivation. The antisocial act (stealing, bedwetting, etc.) is an enactment that signifies an environmental failure at the time of relative dependence.

In Winnicott's thesis, the antisocial tendency indicates that the infant had experienced a good-enough environment during the time of absolute dependence that was subsequently lost. Therefore the antisocial act is a sign of hope that the individual will rediscover the good experience of the time before the loss occurred.

The antisocial tendency is not a diagnosis and applies to both children and adults.

Winnicott makes a distinction between the antisocial tendency and delinquency, although both stem from the same root–deprivation.

1   The evacuation experience

Winnicott's discovery that the antisocial tendency was a sign of hope evolved from his work during the Second World War, when he became Consultant Psychiatrist for the Government Evacuation Scheme in a reception area outside London. The impact on Winnicott of this experience gave rise to many talks and broadcasts during the war and post-war, where the themes linked with separation and deprivation of home life are explored. Some of these talks were posthumously published along with other papers written some time after the war and are to be found in the collection entitled Deprivation and Delinquency (1984a).

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Medium 9781855754249

CHAPTER FOUR: Analysis of a little girl with an autistic syndrome

Kate Barrows Karnac Books ePub

Velleda Cecchi

This paper is based on clinical material from analysis of a 28-month-old girl who developed an autistic syndrome as a reaction to a traumatic situation. I shall deal here only with three aspects: (1) the patient's peculiar way of communicating, (2) the use made of this peculiar communicating mode for the technical approach, and (3) the social context in which the therapeutic process took place and its influence on the analytic field.

Mariela was thin, graceful and fair-haired, with big blue eyes, and very pretty. She did not speak, walked slowly with rigid movements, did not fix her eyes, and looked absent—characteristics which made her look like a lifeless doll. Her maternal grandmother brought her for the first interview. She was a pleasant-looking 54-year-old woman, in a depressive state, who said that the child had not spoken for three months, that she sometimes uttered guttural cries or sounds like “sssssss”, or “ta ta tata ta ta” or “sesesese”. She remained quiet and absent-minded for long periods. For some time she had refused to eat, but at that moment she was eating a bit better, although mainly liquids.

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Medium 9781855754324

Transitional Phenomena

Jan Abram Karnac Books ePub

1   A triple statement on human nature

2   The truly Not-me object is a possession

3   Transitional objects and the journey to symbolism

4   The function of the transitional object

5   Cultural experience

6   Friendship and groups

7   The potential space and separation

8   The essential paradox

T he concept of transitional phenomena refers to a dimension of living that belongs neither to internal nor to external reality; rather, it is the place that both connects and separates inner and outer. Winnicott uses many terms to refer to this dimension—the third area, the intermediate area, the potential space, a resting place, and the location of cultural experience.

Developmentally, transitional phenomena occur from the beginning, even before birth, in relation to the mother–infant dyad. Here is located culture, being, and creativity.

As the infant begins to separate Me from Not-me, going from absolute dependence into the stage of relative dependence, he makes use of the transitional object. This necessary developmental journey leads to the use of illusion, the use of symbols, and the use of an object.

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Medium 9781855757301


Chris Scalzo Karnac Books ePub


“Child analysis of whatever school is built around the child’s

“… It is play that is universal, and belongs to health”

(Winnicott, 1971, pp. 39, 41)

Play is an activity viewed by Winnicott as a form of growth. A healthy, growing child will need to play, and Winnicott also claims within his book, Playing and Reality (1971), that in monitoring a child’s mental health and wellbeing, it is almost possible to disregard all other social dysfunctions if they are able to play creatively. His premise appears to be largely founded upon the importance of play as a facilitator and catalyst for the forming of relationships. He asserts that these relationships, with other people and the child’s world around them, fall into categories of being healthy or unhealthy. The emphasis that play makes on the health of these relationships is in communication, and Winnicott suggests psychotherapy is, in some ways, just a specialized and advanced form of communication through playing. The play, in this case, simply aids communication between the two parties.

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Medium 9781780643960

2: Comparative Mycobacteriology of the Mycobacterium tuberculosis Complex

Edited by H Mukundan, Los Alamos National Laboratory CAB International PDF


Comparative Mycobacteriology of the

Mycobacterium tuberculosis Complex


Stephen V. Gordon1* and Marcel A. Behr2

University College Dublin, Dublin, Ireland; 2McGill University Montreal and McGill International TB Centre Montreal, QC, Canada


I feel quite confident that the comparative study of tubercle bacilli will lead to some definite understanding on certain important questions, and eventually to more light on the whole subject of tuberculosis from the preventive as well as the therapeutic side.

(Theobald Smith, 1898)

The Mycobacterium tuberculosis complex (MTBC) is a group of highly genetically related pathogens that cause tuberculosis (TB) in mammalian species. However, the very name of the complex underlines the fact that our knowledge of these pathogens is dominated by studies on the human pathogen, M. tuberculosis. Of course this is entirely justified; M. tuberculosis is a major global pathogen that exacts a horrendous burden in terms of mortality and morbidity so it is appropriate that it is the cornerstone of the complex. In the same way as M. tuberculosis is the best studied human

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Medium 9781609947897

4 Tipping the Scales: Scaling Up to Save Lives

Eric Bing Berrett-Koehler Publishers ePub

Many exciting experiments and innovations in global health have the potential to dramatically improve the lives of millions in developing countries. These solutions do not need further scientific or technological refinement, but rather a business model that can disseminate these products and services to those in need in both urban and rural settings.

A critical part of the solution to creating impacts in global health is scaling up what worksgetting the right solution to the right customerall over the world.

There are poor-quality health programs that, when scaled, remained of low quality. Scaling bad programs may do more harm than good. And a number of health programs have achieved excellent quality outcomes in localized settings, but have generally not been able to replicate and scale their successes to other settings.1 What we need are high-quality global health products and services that can simultaneously achieve scale while maintaining high quality.


To scale quality programs in high-resource settings, we need leadership; effective collaboration with communities and governments; and monitoring, evaluation, and accountability.2 But these prescriptions are insufficient for guiding scaling efforts in impoverished regions, where infrastructure is weak, resources are minimal, and education is not necessarily perceived as a right, or even a need. The obstacles are many, yet a handful of programs have successfully reached scale in these extremely challenging conditions.3

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Medium 9780253014429

5 American Foundations in Twentieth-Century China

Jennifer Ryan Indiana University Press ePub

Zi Zhongyun and Mary Brown Bullock

AMERICAN FOUNDATIONS HAVE played a frequently constructive role in China, maintaining cross-cultural engagement amid the political and social upheavals of China’s twentieth century and supporting the quest for modernization and reform. This engagement has significantly though by no means exclusively focused on philanthropy for health, with organizations such as the Rockefeller Foundation (RF) and the China Medical Board (CMB) meaningfully contributing to the spread of scientific medicine and the improvement of public health. As this paper will show, the history of American foundations’ work in China during the twentieth century holds lessons for the twenty-first: as China emerges as a world power, striving to make its ongoing development sustainable and to grow its own philanthropic institutions, American foundations’ successes and setbacks reveal the ability of philanthropic partnerships to transcend international differences and to make both China and the world a better, healthier place.

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Medium 9781576759448

CHAPTER FOUR The 16 Warning Signs of Trauma Exposure Response

Laura van Dernoot Lipsky Berrett-Koehler Publishers ePub

As you make your way through the 16 signs of trauma exposure response, take note of how you feel. For some people I work with, the experience of analyzing their trauma exposure response can be quite unsettling. Recently, at a statewide cervical cancer conference where we were reviewing trauma exposure response, a participant leaned over to her colleague and said, “I swear she must have talked to my partner.” Her colleague responded, “Well, then she gets around, because she most certainly has talked to mine as well!” Some feel as if there’s an intervention being planned and they alone are at the center of it. Some worry that there is something wrong with them. Still others become immediately overwhelmed. I remind them, and I would like to remind my readers, that whether you identify with many of the warning signs, a few, or none at all, you are more than okay. It is perfectly normal to have a response to trauma exposure. This means you still have the capacity to connect your internal world with the external reality, and this, as you know, is a great blessing. As hard as it is to feel our full range of feelings, still more damaging are our attempts to not feel. Even if we don’t believe we have any trauma exposure response, what compassion and insight can we bring to those who do? As we move ahead, we can honor ourselves for having the courage to look honestly at our own behavior. Already, we have taken the first step toward more effective trauma stewardship.

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Medium 9780253009227

7 - Accessible Futures, Future Coalitions

Alison Kafer Indiana University Press ePub

A vital moment in coalitional political rhetoric is its ability to construct connections among struggles that may be not only diverse, but opposed to one another in many respects.

—Catriona Sandilands, The Good-Natured Feminist

WHEN DESCRIBING DISABILITY studies to my students, I often draw on Douglas Baynton's insight that “disability is everywhere in history once you begin looking for it.”1 For Baynton, “looking for it” entails not only recovering the stories of disabled people or tracing histories of disability discrimination but also exploring how notions of disability and able-mindedness/able-bodiedness have functioned in different contexts. Baynton issues his provocation to historians, but disability studies scholars in other fields have extended its reach, pushing their own colleagues to recognize disability as a category of analysis. Deeply influenced by and indebted to this work, I use this final chapter to read Baynton's assertion differently. Rather than direct his insight outward, to those not currently working in disability studies, I turn inward, directing it to the field itself. If “disability is everywhere…once you begin looking for it,” where do we, as disability studies scholars and activists, continue not to look? Where do we find disability and where do we miss it? In which theories and in which movements do we recognize ourselves, or recognize disability, and which theories and movements do we continue to see as separate from or tangential to disability studies?

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Medium 9780433308829

CHAPTER FIVE. Primary self, primary narcissism and related concepts

Michael Fordham Karnac Books ePub

In this and the next chapter, I shall bring the concepts that have been outlined into relation with comparable formulations by psychoanalysts. In the process essentially Jungian ideas will be thrown into relief and amplified.

In Children as individuals, I developed a concept of the primary self; in this paper I shall relate it to Freud’s theory of primary narcissism (Freud, 1914, 1916-17, 1920, 1923, 1924, 1940). But before doing so I shall discuss another and seemingly opposed speculation, which states that a baby is psychically part of his mother; it represents the only other significant though radically different view of the earliest psychic states in infancy.

Before we go into each theory further, here are some simple facts about a baby that are easily lost sight of though essential to keep in mind. After birth he spends the main part of his life sleeping or dozing, but from time to time he wakes up and requires attention. The infant may awake hungry and cry, or his mother may anticipate his need and pick him up before he signals to her. When she does so and holds him, he will reach an upright position; then he initiates approach behaviour, a sequence of movements that lead, with his mother’s help, to taking the nipple and sucking it.

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