A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room.

Background: Delays in the operating room (OR) can lead to increased hospital costs as well as patient and provider dissatisfaction. Starting the first case on time in the OR can potentially prevent subsequent delays. We designed a quality improvement project to improve the first case on-time starts in the pediatric OR at a tertiary care children's hospital.

A pharmacy-led () chapter 800 compliance collaborative at an academic medical center.

Purpose: One academic medical center's efforts to move toward compliance with requirements of () chapter 800 through a multidepartmental collaborative initiative are described.

Summary: Requirements of general chapter 800 (enforceable as of December 2019) address the handling of hazardous drugs (HDs) throughout the entire operational and clinical cycle, from receiving to compounding, administration, and waste disposal. Due to the variety of pharmacy operational areas in which HDs are encountered at University of North Carolina Medical Center (UNCMC), multiple pharmacy managers oversee the safe handling of HDs.

Associations with worry about dying and hopelessness in ambulatory ovarian cancer patients.

Objective: Women with ovarian cancer face a poor prognosis, with prolonged periods of treatment but relatively high levels of physical functioning. Their thoughts and feelings regarding the prospect of dying are complex and have not been adequately studied. Various demographic, medical and psychosocial factors were examined to determine their independent associations with fear of dying and hopelessness in a cross-sectional design.

Effects of treatment factors, comorbidities and health-related quality of life on self-efficacy for physical activity in cancer survivors.

Objective: The physical and psychological benefits of exercise for cancer survivors are well documented. Researchers have examined self-efficacy (SE) as a target for promoting exercise; however, the predictors of SE, including treatment factors and comorbidities, have not been examined extensively. The purpose of this cross-sectional analysis was to examine how variables related to cancer and cancer treatment, comorbid health problems, health-related quality of life (QOL), and depression relate to SE for physical activity in cancer survivors.

Sexual dysfunction and spousal communication in couples coping with prostate cancer.

Objective: To characterize the sexual function of both prostate cancer patients and their partners, and to examine whether associations between sexual dysfunction and psychosocial adjustment vary depending on spousal communication patterns.

Methods: In this cross-sectional study, 116 prostate cancer patients and their partners completed psychosocial questionnaires.

Results: Patients and partners reported high rates of sexual dysfunction.

Dimensions of physical activity and their relationship to physical and emotional symptoms in breast cancer survivors.

Background: Many breast cancer survivors experience long term sequelae, including fatigue, decreased physical functioning, pain, and psychological distress. Physical activity can ameliorate these problems, but there is little research on how activity should be performed to be most beneficial. This study explores how dimensions of physical activity (total energy expenditure, frequency, and duration) are associated with symptoms among breast cancer survivors.

Effects of relationship maintenance on psychological distress and dyadic adjustment among couples coping with lung cancer.

Objective: Relationship maintenance strategies help to ensure the continuation of valued relationships by keeping them at a certain level of intimacy. This study evaluated how lung cancer patients' and spouses' efforts to maintain their relationships affected their psychological and marital adjustment over time.

Design: Psychosocial questionnaires were administered within 1 month of lung cancer treatment initiation (baseline) and 3 and 6 months later to 158 lung cancer patients and their spouses.

Does talking about their relationship affect couples' marital and psychological adjustment to lung cancer?

Introduction: Relationship talk refers to talking with a partner about the relationship, what one needs from one's partner, and/or the relationship implications of a shared stressor. This prospective study examined the effects of relationship talk on couples' psychosocial adaptation to lung cancer.

Methods: A total of 169 patients (63% male) and 167 of their partners completed a series of questionnaires within 4-weeks of treatment initiation for newly diagnosed lung cancer (baseline).

An 8-week, double-blind, randomized, placebo-controlled study of olanzapine long-acting injection in acutely ill patients with schizophrenia.

Objective: To examine the efficacy and tolerability of a new injectable formulation of olanzapine, olanzapine long-acting injection (LAI), relative to placebo for treatment of acutely ill patients with schizophrenia.

Method: Patients with DSM-IV or DSM-IV-TR schizophrenia in this 8-week, double-blind study were randomly assigned to receive 210 mg/2 weeks, 300 mg/2 weeks, or 405 mg/4 weeks of olanzapine LAI or placebo/2 weeks. No oral antipsychotic supplementation was permitted.

All-cause treatment discontinuation in schizophrenia during treatment with olanzapine relative to other antipsychotics: an integrated analysis.

Objectives: Treatment continuation, as measured by time to all-cause treatment discontinuation, is a broad measure of overall treatment effectiveness. This integrated analysis compared the likelihood of discontinuation from olanzapine treatment versus other antipsychotics among patients with schizophrenia.

Methods: Clinical trials of all sponsors were included if they met the following criteria: double-blind, randomized, comparative; duration of 12 weeks or longer; no mandatory discontinuation before 12 weeks; and schizophrenia-spectrum disorders; 20 patients or more per treatment.

D2 receptor occupancy of olanzapine pamoate depot using positron emission tomography: an open-label study in patients with schizophrenia.

A long-acting depot formulation of olanzapine that sustains plasma olanzapine concentrations for over a month after a single injection is currently under development. This multicenter, open-label study explored D(2) receptor occupancy of a fixed dose of olanzapine pamoate (OP) depot given every 4 weeks. Patients (nine male, five female) with schizophrenia or schizoaffective disorder previously stabilized on oral olanzapine were switched to OP depot 300 mg by intramuscular injection every 4 weeks for 6 months.

Characteristics of two alternative schizophrenia remission definitions: relationship to clinical and quality of life outcomes.

Background: The goal of these secondary analyses of clinical trial data was to characterize clinical outcomes in patients with schizophrenia who met symptom severity or duration thresholds for two alternative definitions of remission, and to explore their relationships to improvement duration and quality of life outcomes.

Methods: Definition 1 used threshold criteria for selected PANSS items sustained over at least 6-months Definition 2 used Brief Psychiatric Rating Scale (BPRS) % change, a threshold score for the Clinical Global Improvement-Severity (CGI-S) maintained for at least 8 weeks, and threshold scores for selected BPRS items. Positive and Negative Symptom Scale (PANSS) and Quality of Life scale (QLS) total scores were pooled from 6 clinical trials.

A double-blind, randomized trial to evaluate the pharmacokinetics and tolerability of 30 or 40 mg/d oral olanzapine relative to 20 mg/d oral olanzapine in stable psychiatric subjects.

Background: Prescription monitoring in the United States suggests that oral olanzapine is prescribed in doses that exceed the approved range of 5 to 20 mg/d.

Objective: In this double-blind, randomized study, the pharmacokinetics and tolerability of higher-dose (30 or 40 mg/d) olanzapine were examined relative to the highest approved dose (20 mg/d) among non-treatment-resistant patients with psychiatric illnesses.

Methods: After a 10-day period in which all patients were stabilized on 20 mg/d olanzapine, 37 patients with schizophrenia, schizoaffective disorder, or bipolar I disorder were randomized to receive treatment with olanzapine 20 mg/d for 20 days (group A, n=12), 30 mg/d for 10 days followed by 40 mg/d for 10 days (group B, n=11), or 40 mg/d for 20 days (group C, n=14).

Cross-sectional comparison of fasting lipids in normoglycemic patients with schizophrenia during chronic treatment with olanzapine, risperidone, or typical antipsychotics.

We compared fasting lipids and other metabolic parameters in 211 normoglycemic patients meeting the DSM-IV diagnosis of schizophrenia or schizoaffective disorder undergoing continuous treatment with olanzapine, risperidone, or typical antipsychotics for at least 1 year. Blood samples were obtained after an 11-hour (+/-1 h) observed fast. Olanzapine-treated patients had significantly higher mean fasting triglyceride levels (2.

Randomized pilot test of a lifestyle physical activity intervention for breast cancer survivors.

Objective: This paper will report the results of a pilot test of a 6-month, 21-session intervention to increase breast cancer survivors' physical activity by teaching them to incorporate short periods of moderate activity into their daily routines (lifestyle intervention). The effect of the intervention on physical performance, quality of life, and physical activity are reported.

Methods: Sixty breast cancer survivors were randomized to either a lifestyle intervention or a standard care control group.

Is quality of life among minimally symptomatic patients with schizophrenia better following withdrawal or continuation of antipsychotic treatment?

This secondary report from our 52-week, double-blind, relapse prevention trial tested whether stable patients with schizophrenia who were taken off active drug treatment would experience greater improvements in long-term quality of life than those who were continued on antipsychotic treatment. On average, Heinrichs-Carpenter Quality-of-Life Scale total scores improved by 4.3 +/- 10.

Social constraints and spousal communication in lung cancer.

The Social Cognitive Processing Model suggests that talking with others facilitates cognitive and emotional processing of experiences such as cancer if the social context in which these discussions take place is supportive and positive. Despite this, patients and spouses may inadvertently constrain each other's attempts to process and cope with the disease. To our knowledge, no previous studies have directly examined the effect of lung cancer on the spousal relationship.

A retrospective comparison of cumulative time spent in remission during treatment with olanzapine or risperidone among patients with schizophrenia.

Background: Available studies suggest comparable efficacy of olanzapine and risperidone for the treatment of schizophrenia over the short term.

Method: This retrospective analysis of data from a 28-week, double-blind, schizophrenia trial compared the cumulative amount of time that patients met severity criteria for remission during olanzapine (10-20 mg/day) or risperidone (4-12 mg/day) treatment.

Results: The percentage cumulative time spent in remission was 40% for olanzapine- and 31% for risperidone-treated patients (P = 0.

Intramuscular olanzapine and intramuscular haloperidol in acute schizophrenia: antipsychotic efficacy and extrapyramidal safety during the first 24 hours of treatment.

Objective: To determine the antipsychotic efficacy and extrapyramidal safety of intramuscular (i.m.) olanzapine and i.

A double-blind, randomized, placebo-controlled trial of olanzapine in the prevention of psychotic relapse.

Sustained response to antipsychotic therapy is an important outcome measure for patients with psychotic disorders. Placebo control in studies of relapse prevention contributes valuable information yet provokes much debate. This study, using placebo as a control, evaluated olanzapine's efficacy in preventing a psychotic relapse.

Cancer worry is associated with abnormal prostate-specific antigen levels in men participating in a community screening program.

An accumulating body of research suggests that psychological factors can affect physiological parameters. We assessed the association between the perceived risk of prostate cancer, prostate cancer-specific worry, and cancer-related symptoms and prostate-specific antigen (PSA) levels or the findings from digital rectal examination (DRE) in a large sample of men undergoing a free prostate cancer screening. Participants (n = 1635) completed a background questionnaire and a questionnaire that assessed their prostate cancer history, screening behavior, perceived risk of prostate cancer, and prostate cancer worry.

A comparison of the efficacy and safety of olanzapine versus haloperidol during transition from intramuscular to oral therapy.

Background: Acutely agitated patients with schizophrenia who receive intramuscular (IM) medications typically are switched to oral (PO) antipsychotic maintenance therapy.

Objective: The goal of this study was to assess the efficacy and safety of olanzapine versus those of haloperidol during transition from IM to PO therapy. We used additional data from a previously reported trial to test the hypothesis that the reduction in agitation achieved by IM olanzapine 10 mg or IM haloperidol 7.

Effects of intramuscular olanzapine vs. haloperidol and placebo on QTc intervals in acutely agitated patients.

Prolongation of the QTc interval has been reported during treatment with oral antipsychotic agents and may be more pronounced during parenteral administration. Pooled QTc interval data from acutely agitated patients across four double-blind trials were compared. Databases included: placebo-controlled [two schizophrenia, one bipolar mania trials (n=565)]; haloperidol-controlled [two schizophrenia trials (n=482)]; geriatric placebo-controlled [1 dementia trial (n=204)].