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This past December, substance abuse experts Diah Setia-Utami, M.D. of Indonesia and Imisioluwa O. Ibikunle, M . of Nigeria visited Didi Hirsch Community Mental Health Center's Via Avanta facility to gain insight on women's substance abuse treatment. Dr. Setia-Utami and Ms. Ibikunle were participants in a training presented by UCLA's Integrated Substance Abuse Program and the Los Angeles County Department of Public Health Alcohol and Drug Program Administration. The training prepared participants to return to their home nations and, in turn, teach other health care workers about the best substance abuse treatment methods. Via Avanta, Didi Hirsch's residential treatment facility specifically for addicted women and their children, is unique in that free standing womens substance abuse treatment is rare and underfunded in California. Holly McCravey, Program Director for Via Avanta, was happy to lend her expertise to help provide the best treatment for women in Nigeria and Indonesia. "Though substance abuse crosses socioeconomic, cultural and ethnic lines, our gender-specific treatment helps women recover with greater and longer-term success. This approach may be the most effective for women around the world, " said Ms. McCravey. Upon visiting, both Dr. Setia-Utami and Ms. Ibikunle were impressed by Via Avanta's innovative treatment program. Dr. Setia-Utami stated, "It was wonderful visit for me because we don't have special services for women in my country. I was surprised that this center carried both clients and their children together in the program in such a good facility." Said Ms. Ibikunle, "I really impressed by the set up. The staff are wonderful, caring and dedicated. The babies are well taken care of, the toddlers are given enough attention. I believe in my heart that they are not missing anything at all. I believe with this facility, the clients will do well!
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In those circumstances the Court of First Instance went on to examine whether having regard to the actual conduct of the wholesalers following the adoption by the applicant of its new policy of restricting supplies, the Commission could legitimately conclude that they acquiesced in that policy paragraph 124 of the judgment under appeal ; ." 68. Addressing the Commission's argument on the facts, the ECJ said this in paragraphs 140 and 141 of its judgment ; : "140. By these pleas, the appellants are seeking to challenge the assessment by the Court of First Instance that the Commission could not effectively rely on the case-law precedents referred to in order to call into question the analysis which led the Court of First Instance to conclude that in this case acquiescence of the wholesalers in Bayer's new policy was not established . 141. 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Patients would show up in our offices with textbook cases of conjunctivitis such as those described above. Time and time again, a patient will present with a one-to-three-day history of an irritation to one or both eyes. When asked if there is associated burning or itching, the response is either yes or no to both symptoms, with neither being predominant. There is usually no significant discharge present. Slit-lamp biomicroscopy generally reveals a mild amount of injection, both to the bulbar and palpebral conjunctiva. The inferior palpebral conjunctiva may have a mild follicular response along with the hyperemia, but this is by no means diagnostic. The lids have no unusual amount of scurf or oil. Having no clue as to what is causing the conjunctival hyperemia, you excuse yourself from the exam room to perform a minor emergency procedure -- to brush the dust off the textbook and look under conjunctivitis. When an exhaustive search still leaves you clueless, do not lose hope. This is a classic case of "nonspecific conjunctivitis." The most common cause of nonspecific conjunctivitis is dry eyes, often complicated by patient self-medication with an OTC vasoconstrictor. When the ocular surface is lacking its protective coating provided by a normal tear film, the conjunctiva can become inflamed, creating a symptomatic patient who previously noticed very little irritation. Environmental toxins such as gasoline or exposure to dyes may trigger this nonspecific response. And, last but not least, many times the etiology to the inflammation is unknown, leaving one curious as to the exact cause. Soparkar et al1 have identified vasoconstrictor abuse as a common cause of chronic, nonspecific conjunctivitis. Nonprescription decongestant eye drops can produce hyperemia of the conjunctiva by allergic, toxic, and pharmacological mechanisms. The "get the red out" products contain alpha-adrenergic, vasoconstrictive and clarithromycin, for instance, bentyl interactions.
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2.1. ISDB commits itself and its member bulletins to prioritise areas where independent research is specifically and urgently needed, thus contributing to lobbying with public health authorities and other agencies ; , to provide finance for and the streamlining of procedures that could make independent research easier and more efficient. The recently enforced policy of AIFA Italian Drug Agency ; is a promising example of this. 2.2. More intensive connections will be sought and trialled, mainly with general practice organizations and consumer associations, to identify themes and to promote projects capable of producing independent information e.g. through pragmatic trials and outcomes research ; in controversial therapeutic and preventive problems. The experience with the European branch of WONCA World Organization of Family Doctors ; in 2006 appears to be a step in this direction. 2.3. A special effort will be made to test and to promote the use of ISDB bulletins as a preferred tool for CME programs. This should allow at the same time a permanent critical appraisal of drug promotion. The experience of Prescrire is, among others, notable in this area. 3. SURVEILLANCE OF GUIDELINES Evidence-based treatment guidelines are considered a good tool to implement evidence-based medicine. Nevertheless the development process for treatment guidelines is often influenced, or even directly sponsored, by the pharmaceutical industry and recommendations can be biased toward excessive medicalization, thus arousing the suspicion of a "disease mongering". It is important to make health professionals, organizations and ISDB members aware of this problem and to promote more judicious use of treatment guidelines. Based on the preparation and wide circulation of a background methodological document on how to assess the independence and reliability of treatment guidelines, the following actions will be advocated: 3.1. ISDB and its members commit themselves to the active monitoring and critical appraisal of guidelines produced by scientific societies, as well as by national and international agencies in areas imporISDB Newsletter and lioresal.

Important reasons from a list of nine ; for why they did not always ask for a pharmacist's advice. According to the results, choosing the most important two reasons may not have been an effective approach. A very high proportion of participants n 121 921; 13 percent ; did not answer this question and, for those who did answer it n 800 921 ; , nearly half n 371 800; 46.3 percent ; did not go on to select two items. It may have been wiser to ask participants to check "all that apply" or simply ask them to select the most important one from the reason pool. Choice of wording for scales or in sentences may have been problematic. Although five- and seven-point Likert scales and the option of neutral are commonly used to determine agreement on various statements in similar studies, wording for the middle point is controversial. The term neutral could have meant a respondent did not have any opinion on the issue, had an opinion but felt it lay between agreement and disagreement, or they did not understand the meaning of the statement. While it did not appear to be an issue during pre-testing, the term potency seemed to confuse some in the formal study. Around three in ten respondents selected neutral for this statement for both pharmacy and convenience store. For those who selected this option, 14 respondents commented that they did not understand the exact meaning of potency in the context given. Adjectives such as "good selection", "very few side effects", "low prices", "good quality" are especially open to interpretation by consumers during questionnaire completion and may have affected our results. Other terminology open for interpretation was use of the phrase "for any reason" within the context of visits to a convenience store. Respondents may not have included the simple act of paying for gasoline as constituting a visit under the terms of the questionnaire ; , thinking that a more formal act of entering the location for a product purchase would be required. If so, figures on numbers of visits may have been artificially low. Given the blurring of lines within the retail environment as to what is truly a pharmacy or a grocery store, it may be difficult for some to distinguish between the two. Although results of the pre-test did not reveal any apparent difficulty, it could exist. This may have affected results that called for comparisons of pharmacies to convenience stores. Table 2. Screening tools, cut-off scores and instruments used to assess treatment efficacy and benazepril.
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