Prospective surveillance for invasive fungal infections in hematopoietic stem cell transplant recipients, 2001-2006: overview of the Transplant-Associated Infection Surveillance Network (TRANSNET) Database.

Background: The incidence and epidemiology of invasive fungal infections (IFIs), a leading cause of death among hematopoeitic stem cell transplant (HSCT) recipients, are derived mainly from single-institution retrospective studies.

Methods: The Transplant Associated Infections Surveillance Network, a network of 23 US transplant centers, prospectively enrolled HSCT recipients with proven and probable IFIs occurring between March 2001 and March 2006. We collected denominator data on all HSCTs preformed at each site and clinical, diagnostic, and outcome information for each IFI case.

Risk prediction in pediatric cancer patients with fever and neutropenia.

Background: To identify predictors for 2 risk measures-"proven invasive bacterial infection or culture-negative sepsis (IBD)" and "clinical complications (CC)"-in pediatric cancer patients with fever and neutropenia (FN).

Methods: Records of 390 patients with FN hospitalized over 2 years were reviewed. For the 332 who met inclusion criteria, one FN episode was randomly selected.

Progress examination for assessing students' readiness for advanced pharmacy practice experiences.

Objectives: To create a valid assessment tool to evaluate the readiness of pharmacy students for advanced pharmacy practice experiences (APPEs).

Design: The Triple Jump Examination (TJE) was tailored to the 4-year, 2-plus-2 curriculum of the College. It consisted of (1) a written, case-based, closed-book examination, (2) a written, case-based open-book examination, and (3) an objective structured clinical examination (OSCE).

Implementation of and barriers to routine HIV screening for adolescents.

Objectives: We developed and implemented a process for routine HIV screening, and we report screening practices and acceptance among adolescents at a large, urban, pediatric emergency department (ED).

Methods: We surveyed health care providers regarding their knowledge and beliefs about HIV and generated a protocol for routine HIV screening. Free, routine, opt-out, HIV screening was offered for all adolescents (13-18 years of age) presenting for care in the ED.

A People to People nursing experience in Poland.

Introductory note by Cynthia Spry, RN, MA, MSN, CNOR, column coordinator: Since 1956, the People to People Citizen Ambassador Programs have offered unique travel opportunities that foster local and global networking and provide opportunities for professionals from around the world to interact and engage in cultural activities, seminars, and humanitarian efforts. Since the 1980s, several AORN leaders have led perioperative nurses on People to People trips to China, Russia, and other countries where they have shared and learned much about perioperative practice and once again confirmed that, despite differences in available resources, perioperative nurses around the world have much in common. Just as perioperative nurses in the United States are proud of their contributions to patient safety, the ongoing movement to evidence-based practice, and their commitment to advancing the profession, nurses in less developed countries are too.

Visions for required postgraduate year 1 residency training by 2020: a comparison of actual versus projected expansion.

Study Objective: To explore the feasibility of expanding postgraduate year (PGY) 1 residency training as proposed by the American College of Clinical Pharmacy and American Society of Health-System Pharmacists (ASHP).

Design: Prospective survey analysis.

Data Source: The ASHP Online Residency Directory was used to obtain PGY1 residency program data from June 2007-June 2008.

Etiology and clinical course of febrile neutropenia in children with cancer.

Background: The etiology, clinical course, and outcome of fever and neutropenia (FN) in children with cancer using the current FN guidelines and diagnostic resources in the United States have not been well described.

Patients And Methods: Medical records of a randomly selected FN episode per patient during 2004-2005 at a pediatric oncology center were reviewed. Patients were managed as per institutional FN guidelines and blood cultures collected in continuously read BACTEC bottles.

Quantitative ultrasound and bone health.

This review of quantitative ultrasound (QUS) and bone health uses the current literature to summarise the clinical and research effectiveness of QUS. QUS has been demonstrated to have the ability to predict fracture, particularly at the hip. However, the magnitude of prediction is fracture-site, measurement-site and device dependent.

Perioperative fluid management.

Technological advances have changed how traditional surgical procedures are performed. New knowledge and surgical skills are required to effectively monitor the patient and manage fluids administered perioperatively. Today, selective fluids are used in a variety of surgical specialties.

Pharmacokinetics and safety of caspofungin in older infants and toddlers.

Although information about the efficacy and safety experience with caspofungin at 50 mg/m(2) daily is available for children and adolescents, the dosing regimen in infants and toddlers 3 to 24 months of age has yet to be established. We studied the pharmacokinetics and safety of caspofungin at 50 mg/m(2) once daily in nine patients 10 to 22 months (median, 13 months) of age with fever and neutropenia who received caspofungin once daily for 2 to 21 (mean, 9.3) days.

Depressive symptoms in patients with type 2 diabetes in the ambulatory care setting: opportunities to improve outcomes in the course of routine care.

Objectives: To assess the frequency of untreated, self-reported depressive symptoms in a cross section of adult ambulatory patients with type 2 diabetes and to identify demographic and/or clinical characteristics associated with depressive symptoms in study patients.

Design: Cross-sectional study.

Setting: Three ambulatory care clinics in the southwestern United States in fall 2005.

Capacity of hospitals to partner with academia to meet experiential education requirements for pharmacy students.

Purpose: Current hospital and health-system participation in and the future capacity for experiential education for pharmacy students was investigated.

Methods: An online survey of ASHP members identified as U.S.

POEM, A 3-dimensional exon taxonomy and patterns in untranslated exons.

Background: The existence of exons and introns has been known for thirty years. Despite this knowledge, there is a lack of formal research into the categorization of exons. Exon taxonomies used by researchers tend to be selected ad hoc or based on an information poor de-facto standard.

Galactomannan antigenemia in pediatric oncology patients with invasive aspergillosis.

Background: Diagnosing invasive aspergillosis is difficult but might be improved by detection of circulating galactomannan. Although galactomannan antigenemia has been well studied in the detection of invasive aspergillosis in adult patients, little is known about the expression of circulating galactomannan in immunocompromised children with invasive aspergillosis.

Methods: We studied the expression of galactomannan antigen by enzyme immunoassay (EIA) in 990 serum samples from 56 pediatric oncology patients (ages 3 months to 18 years) of whom 17 had proven or probable invasive aspergillosis defined by the European Organization for Research and Treatment of Cancer-Mycoses Study Group criteria.

Education and training of pharmacists: comments on sustaining continuous improvement.

Objective: To examine three approaches to improving the education and training of pharmacists and their interrelationships.

Data Sources: American Association of Colleges of Pharmacy, American Society of Health-System Pharmacists, National Center for Education Statistics, and peer-reviewed pharmacy literature.

Summary: The education of pharmacists continues to change based on a paradigm of continuous quality improvement and broad agreement that many newly graduated pharmacists are not ready to practice in all practice settings.

Factors influencing the pharmacy faculty workforce.

In 2005, the Council of Faculties and the Council of Deans within the American Association of Colleges of Pharmacy (AACP) formed a task force to review the status of the pharmacy faculty workforce and to identify factors that may influence the supply of and demand for pharmacy faculty members. This manuscript summarizes the Task Force on Faculty Workforce's findings and describes specific strategies needed to address the various issues facing the academy. Based on Task Force predictions, the academy will need approximately 1200 new faculty members over the next 10 years due to the creation of new pharmacy programs, the expansion of existing programs, faculty retirements, and recurring vacant faculty positions.

Pediatric invasive aspergillosis: a multicenter retrospective analysis of 139 contemporary cases.

Objective: Invasive aspergillosis is a major cause of morbidity and mortality in immunocompromised children. Invasive aspergillosis has been well characterized in adults; however, the incidence and analysis of risk factors, diagnostic tools, treatments, and outcomes have not been well described for a large cohort of pediatric patients.

Methods: We conducted the largest retrospective review of contemporary cases of proven and probable pediatric invasive aspergillosis diagnosed at 6 major medical centers (January 1, 2000, to July 1, 2005).

A pilot investigation of teachers' perceptions of psychotropic drug use in schools.

Objective: Children's behavior at school often leads to parental interest in seeking physician treatment. This study examines teachers' knowledge and perceptions of psychotropic drug use in schools.

Method: Structured interviews were conducted with 27 general education teachers from a diverse representation of elementary schools within central Michigan.

Intracellular pharmacokinetics of once versus twice daily zidovudine and lamivudine in adolescents.

Zidovudine (ZDV) and lamivudine (3TC) metabolism to triphosphates (TP) is necessary for antiviral activity. The aims of this study were to compare ZDV-TP and 3TC-TP concentrations in adolescents receiving twice daily (BID) and once daily (QD) regimens and to determine the metabolite concentrations of ZDV and 3TC during chronic therapy on a QD regimen. Human immunodeficiency virus-infected patients (12 to 24 years) taking ZDV (600 mg/day) and 3TC (300 mg/day) as part of a highly active antiretroviral therapy regimen received QD and BID regimens of ZDV and 3TC for 7 to 14 days in a crossover design.

New pharmacist supply projections: lower separation rates and increased graduates boost supply estimates.

Objective: To revise the 2000 Bureau of Health Professions Pharmacist Supply Model based on new data.

Design: Stock-flow model.

Setting: United States.

Examination of state-level changes in the pharmacist labor market using Census data.

Objective: To examine long-term changes in the U.S. pharmacist labor market across states.

Evidence for an additional disulfide reduction pathway in Escherichia coli.

An Escherichia coli cell-free protein synthesis cell extract has been created that lacks all known cytoplasmic disulfide reduction pathways but still retains significant reductase activity. Oxidized glutathione was partially stabilized by deleting the gene for glutathione reductase. To avoid previously reported AhpC mutations, thioredoxin reductase was only removed after extract preparation.